Tian Zhaoxia, Zhang Yue, Li Hongmei, Lv Xiaochun, Wang Quanyi, Tian Weiwei
Department of Nursing, Fenyang College of Shanxi Medical University, Fenyang, Shanxi, China.
Department of Cardiovascular Medicine, Fenyang Hospital of Shanxi Province, Fenyang, Shanxi, China.
Front Cardiovasc Med. 2025 Aug 29;12:1652844. doi: 10.3389/fcvm.2025.1652844. eCollection 2025.
The global demographic shift toward aging populations has precipitated a significant rise in coronary heart disease (CHD) prevalence among older adults, positioning health promoting lifestyles as a critical component of healthy aging initiatives. Despite increasing recognition of psychosocial factors in chronic disease management, the complex pathways influencing health promoting lifestyles adoption in elderly CHD patients remain insufficiently understood. Current research lacks theoretically grounded investigations examining how cognitive and social determinants interact to shape health behaviors in this vulnerable population.
Based on social cognitive theory, this study aims to explore the influencing factors of health-promoting lifestyles in elderly patients with CHD and the path relationships among them.
A cross-sectional study was conducted from a tertiary care hospital. Based on social cognitive theory, the Health Promoting Lifestyle Scale and its related research tools were adopted. Structural equation modeling (SEM) elucidated direct and indirect relationships between variables, supported by correlation analyses and model fit statistics.
236 eligible elderly patients with CHD participated in this study. Analysis of the results showed that health literacy, perceived social support, and general self-efficacy had a direct positive effect on health-promoting lifestyles, health anxiety has a direct negative effect on health-promoting lifestyles, and perceived social support, self-efficacy, and health anxiety had significant indirect effects on health-promoting lifestyles.
This study establishes an social cognitive theory-informed framework where psychosocial resources and cognitive appraisals synergistically influence health behaviors in older adults. The centrality of self-efficacy as a mediator highlights its role in translating environmental supports into sustainable lifestyle changes. Based on the pathway relationships among various factors identified in the study, clinical nursing can construct a comprehensive nursing model. During the nursing process, a comprehensive assessment of the patients' various indicators should be conducted, and personalized nursing plans should be formulated according to the assessment results. It is necessary to organically integrate aspects such as improving health literacy, strengthening social support, enhancing self-efficacy, and alleviating health anxiety to provide patients with all-round nursing services.
全球人口向老龄化转变，导致老年人群中心脏病（CHD）患病率显著上升，这使得促进健康的生活方式成为健康老龄化倡议的关键组成部分。尽管慢性病管理中社会心理因素的重要性日益受到认可，但影响老年冠心病患者采用促进健康生活方式的复杂途径仍未得到充分理解。目前的研究缺乏基于理论的调查，以探讨认知和社会决定因素如何相互作用，从而塑造这一脆弱人群的健康行为。
基于社会认知理论，本研究旨在探讨老年冠心病患者促进健康生活方式的影响因素及其之间的路径关系。
在一家三级医院进行横断面研究。基于社会认知理论，采用健康促进生活方式量表及其相关研究工具。结构方程模型（SEM）阐明了变量之间的直接和间接关系，并辅以相关分析和模型拟合统计。
236名符合条件的老年冠心病患者参与了本研究。结果分析表明，健康素养、感知社会支持和一般自我效能感对促进健康的生活方式有直接的正向影响，健康焦虑对促进健康的生活方式有直接的负向影响，感知社会支持、自我效能感和健康焦虑对促进健康的生活方式有显著的间接影响。
本研究建立了一个基于社会认知理论的框架，其中社会心理资源和认知评估协同影响老年人的健康行为。自我效能感作为中介的核心地位凸显了其在将环境支持转化为可持续生活方式改变方面的作用。基于研究中确定的各种因素之间的路径关系，临床护理可以构建一个全面的护理模式。在护理过程中，应对患者的各项指标进行全面评估，并根据评估结果制定个性化护理计划。有必要将提高健康素养、加强社会支持、增强自我效能感和减轻健康焦虑等方面有机结合起来，为患者提供全方位的护理服务。
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