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探索慢性肾脏病管理中专业角色与行为意图之间的关系:一项针对中国上海基层和专科医疗专业人员的横断面研究。

Exploring the relationship between professional roles and behavioural intentions in chronic kidney disease management: a cross-sectional study among primary and specialist health professionals in Shanghai, China.

作者信息

Wu Liutao, Wang Wenyi, Liang Yan

机构信息

Fudan University School of Nursing, Shanghai, Shanghai, China.

Fudan University School of Social Development and Public Policy, Shanghai, Shanghai, China

出版信息

BMJ Open. 2025 Jan 8;15(1):e083708. doi: 10.1136/bmjopen-2023-083708.

Abstract

OBJECTIVES

General practitioners, nephrologists and renal nurses play key roles in professional integration in chronic kidney disease (CKD) management. Professional roles may influence professionals' behavioural intentions, namely, the degree to which individuals formulate behavioural plans to attain a behavioural goal. However, little is known about the relationship between professional roles and their behavioural intentions in CKD management. Therefore, in this study, we aimed to explore the relationship between professional roles and their behavioural intentions in CKD management and the mediating role of normative and functional factors.

DESIGN

Cross-sectional.

SETTING

A cross-sectional survey study was conducted in Shanghai, China.

PARTICIPANTS

A total of 244 responses were obtained, including 145 from general practitioners, 37 from nephrologists and 62 from renal nurses. We used a self-administered questionnaire to collect data through hospital unit/Community Health Service Centre visits. We performed exploratory factor analysis for behavioural intentions in CKD management. The Karlson-Holm-Breen method was used to decompose the total effect of roles on behavioural intentions in CKD management into direct and indirect (ie, mediational) effects and to calculate the mediated percentage.

RESULTS

The indirect effect of personal norm (should CKD management be included in daily work or not) accounted for 51.91% of the total effect of nephrologists on one-to-multiple CKD management intentions and 43.79% of the total effect of renal nurses on one-to-multiple CKD management intentions.

CONCLUSION

Our results support the mediating pathways of personal norms on the relationship between roles and behavioural intentions, but the mediating role of functional factors was not supported. These findings suggest that enhancing the personal norms of general practitioners may benefit their behavioural intentions in CKD management.

摘要

目的

全科医生、肾病科医生和肾脏科护士在慢性肾脏病(CKD)管理的专业整合中发挥着关键作用。专业角色可能会影响专业人员的行为意图,即个体制定行为计划以实现行为目标的程度。然而,对于CKD管理中专业角色与其行为意图之间的关系,我们知之甚少。因此,在本研究中,我们旨在探讨CKD管理中专业角色与其行为意图之间的关系以及规范和功能因素的中介作用。

设计

横断面研究。

地点

在中国上海进行了一项横断面调查研究。

参与者

共获得244份回复,其中全科医生145份,肾病科医生37份,肾脏科护士62份。我们通过医院科室/社区卫生服务中心访视,使用自填式问卷收集数据。我们对CKD管理中的行为意图进行了探索性因素分析。采用卡尔森-霍尔姆-布林方法将角色对CKD管理中行为意图的总效应分解为直接效应和间接(即中介)效应,并计算中介百分比。

结果

个人规范(是否应将CKD管理纳入日常工作)的间接效应占肾病科医生对一对一至多对一CKD管理意图总效应的51.91%,占肾脏科护士对一对一至多对一CKD管理意图总效应的43.79%。

结论

我们的结果支持个人规范在角色与行为意图关系中的中介途径,但不支持功能因素的中介作用。这些发现表明,增强全科医生的个人规范可能有利于他们在CKD管理中的行为意图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06df/11749849/2335828314b8/bmjopen-15-1-g001.jpg

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