Rosenstock I M
Diabetes Care. 1985 Nov-Dec;8(6):610-6. doi: 10.2337/diacare.8.6.610.
Behavioral research on patient compliance with regimens to manage diabetes has suffered from lack of conceptual rigor, although a handful of recent studies and reviews are more theoretically oriented. The present review proposes a comprehensive conceptual framework in the context of learning theory to explain patient compliance and to derive approaches for enhancing compliance. The conceptual framework is the health belief model (HBM) expanded to include the concept of perceived self-efficacy. This expanded model may both serve as an agenda for future research as well as a set of guidelines for the education of patients with diabetes. A variety of educational interventions is recommended for use in patient education provided they succeed in reinforcing relevant health beliefs, behavioral skills, and the sense of self-efficacy. The problem of long-term maintenance, of particular significance in chronic disease management, is addressed by the relapse prevention model derived from social learning theory and emphasizing self-efficacy and the learning of coping skills.
尽管最近有一些研究和综述更具理论导向性，但关于患者对糖尿病治疗方案依从性的行为研究仍缺乏概念上的严谨性。本综述在学习理论的背景下提出了一个全面的概念框架，以解释患者的依从性并推导提高依从性的方法。该概念框架是健康信念模型（HBM）的扩展，纳入了感知自我效能感的概念。这个扩展模型既可以作为未来研究的议程，也可以作为一套针对糖尿病患者教育的指导方针。只要各种教育干预措施能够成功强化相关的健康信念、行为技能和自我效能感，就建议将其用于患者教育。社会学习理论衍生出的复发预防模型解决了长期维持这一在慢性病管理中尤为重要的问题，该模型强调自我效能感和应对技能的学习。
