Zhu Yongli, Liu Ke, Jiang Jinfeng, Cheng Xin, Wang Hao, Long Feiyang, Li Kang, Mu Changping, Cui Lijun
Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
North Sichuan Medical College, Nanchong, Nanchong, China.
BMC Gastroenterol. 2025 Jan 22;25(1):30. doi: 10.1186/s12876-025-03623-6.
Maintaining effective disease control in patients with inflammatory bowel disease (IBD) is both a significant goal and challenge. Drawing on the Common-Sense Model of Self-Regulation (CSM) and related research, this study investigates how IBD activity status influences disease control through both direct and indirect pathways.
A cross-sectional survey was conducted among 310 IBD patients who attended a tertiary general hospital, the leader of the IBD Alliance Group in Chongqing City, between March and August 2024. Structural equation modeling (SEM) was utilized to assess the role and magnitude of various influencing factor pathways. Relying on AMOS26 software, the path effects and magnitude of various factors in the disease control process were analyzed using structural equation modeling (SEM) to test hypothetical models.
A total of 306 valid questionnaires were collected, with a mean IBD-control score of 12.14 ± 3.665. There was a negative link between disease activity and IBD-control (P < 0.01) and a positive correlation between chronic illness management self-efficacy, IBD self-management behavior, and IBD-control (P < 0.01). Path analysis showed that IBD activity negatively predicted IBD control (β = -0.715, P = 0.01). Chronic disease management self-efficacy partially mediated this relationship (β = -0.071, P = 0.012). A significant chain-mediated pathway was identified, where IBD activity affected IBD control via self-efficacy guided by self-management behavior (β = -0.025, P = 0.007). However, the pathway where IBD activity influenced control through self-efficacy and subsequently self-management behavior showed only marginal significance (P = 0.074).
Effective self-management behaviors improve IBD control. High disease activity may reduce chronic disease management self-efficacy, impairing IBD control. Positive feedback loops involving self-management behaviors and enhanced self-efficacy are crucial for better disease control, as patients who perceive positive outcomes are more motivated to maintain these behaviors.
在炎症性肠病（IBD）患者中维持有效的疾病控制既是一个重要目标，也是一项挑战。本研究借鉴自我调节常识模型（CSM）及相关研究，探讨IBD活动状态如何通过直接和间接途径影响疾病控制。
于2024年3月至8月，对重庆市IBD联盟组组长单位——一家三级综合医院的310例IBD患者进行了横断面调查。采用结构方程模型（SEM）评估各种影响因素途径的作用和程度。依靠AMOS26软件，使用结构方程模型（SEM）分析疾病控制过程中各种因素的路径效应和程度，以检验假设模型。
共收集到306份有效问卷，IBD控制评分的平均值为12.14±3.665。疾病活动与IBD控制之间存在负相关（P<0.01），慢性病管理自我效能、IBD自我管理行为与IBD控制之间存在正相关（P<0.01）。路径分析表明，IBD活动对IBD控制具有负向预测作用（β=-0.715，P=0.01）。慢性病管理自我效能部分介导了这种关系（β=-0.071，P=0.012）。识别出一条显著的链式中介途径，即IBD活动通过自我管理行为引导的自我效能影响IBD控制（β=-0.025，P=0.007）。然而，IBD活动通过自我效能进而自我管理行为影响控制的途径仅显示出边缘显著性（P=0.074）。
有效的自我管理行为可改善IBD控制。高疾病活动度可能会降低慢性病管理自我效能，损害IBD控制。涉及自我管理行为和增强自我效能的正反馈回路对于更好地控制疾病至关重要，因为感知到积极结果的患者更有动力维持这些行为。
