Department of Nursing, Graduate School, Pusan National University, Yangsan, Korea.
Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
J Korean Acad Nurs. 2024 May;54(2):162-177. doi: 10.4040/jkan.23136.
This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel's uncertainty in illness theory (UIT).
We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data.
The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior.
The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.
本研究旨在基于米歇尔疾病不确定感理论(UIT)探讨冠心病患者(CAD)不确定性相关因素对健康行为的影响。
采用横断面研究和路径分析方法,对 2020 年 9 月至 2021 年 6 月期间在心血管内科门诊就诊的 228 例 CAD 患者进行调查,采用 SPSS 25.0 和 AMOS 25.0 软件进行数据分析。
最终模型与数据拟合良好,12 条路径中有 11 条具有统计学意义。不确定性正向影响危险感,负向影响自我效能感和机会感;危险感正向影响感知风险;机会感正向影响社会支持、自我效能感、感知获益和意向,负向影响感知风险;社会支持、自我效能感、感知获益和意向正向影响健康行为。感知获益和意向对健康行为的直接影响最大,自我效能感间接影响不确定性与健康行为的关系。
路径模型适用于预测经历不确定性的 CAD 患者的健康行为,当患者经历不确定性时,首先需要提高其自我效能感,其次需要开发能够迅速将不确定性评估为机会、增加健康行为感知获益并提高意向的方案。