基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究

刘玮楚; 王攀; 罗业涛; 王俊; 赵庆华

doi:10.16016/j.1000-5404.201912132

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基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究

公共卫生与预防医学 | 更新时间：2026-01-09

- 基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究
- Self-management behaviors of patients with coronary atherosclerotic heart disease based on health belief model: model building and empirical study
- 第三军医大学学报 2020年42卷第9期页码：953-963
- 作者机构：
  
  1.400016 重庆，重庆医科大学附属第一医院：妇科
  2.100872 北京，中国人民大学健康科学研究所
  3.400014 重庆，重庆医科大学附属儿童医院，儿科研究所
  4.400016 重庆，重庆医科大学附属第一医院：护理部
- 作者简介：
  
  [ 赵庆华, E-mail:qh20063@163.com ZHAO Qinghua, E-mail:qh20063@163.com
- 基金信息：
  
  重庆市卫生计生委医学科研计划项目重点项目(2015ZDXM009);中国研究型医院学会临床护理研究项目(2017-20-19)
- DOI：10.16016/j.1000-5404.201912132
  中图分类号： R192;R492;R541.4
- 收稿：2019-12-12，
  
  修回：2020-01-13，
  
  纸质出版：2020-05-15
- 稿件说明：
移动端阅览
刘玮楚, 王攀, 罗业涛, 等. 基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究[J]. 第三军医大学学报, 2020,42(9):953-963.

Weichu LIU, Pan WANG, Yetao LUO, et al. Self-management behaviors of patients with coronary atherosclerotic heart disease based on health belief model: model building and empirical study[J]. Journal of Third Military Medical University, 2020, 42(9): 953-963.
刘玮楚, 王攀, 罗业涛, 等. 基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究[J]. 第三军医大学学报, 2020,42(9):953-963. DOI： 10.16016/j.1000-5404.201912132.

Weichu LIU, Pan WANG, Yetao LUO, et al. Self-management behaviors of patients with coronary atherosclerotic heart disease based on health belief model: model building and empirical study[J]. Journal of Third Military Medical University, 2020, 42(9): 953-963. DOI： 10.16016/j.1000-5404.201912132.

摘要

目的

基于健康信念模式构建冠心病患者自我管理行为模型并进行实证研究。

方法

采用横断面调查的方法，使用一般情况调查表、社会支持评定量表、冠心病健康素养调查问卷、慢性病自我效能量表和冠心病自我管理量表，于2017年11月至2018年4月对重庆市3家三级甲等医院的280例住院冠心病患者进行问卷调查，并基于结构方程模型分析验证冠心病患者自我管理行为理论模型中各因素间的作用机制。

结果

回收有

效问卷276份(98.57%)，冠心病患者自我管理行为总分为(81.49±13.83)分；相关性分析显示:社会支持、健康素养、自我效能得分与自我管理得分均呈正相关(

=0.229、0.499、0.341，

0.001)；结构方程模型显示:冠心病患者自我管理行为模型拟合较好，影响自我管理行为的因素按作用大小排序为:健康素养(0.533)、自我效能(0.431)、社会支持(0.398)、合并症数目(0.257)、文化程度(0.165)、年龄(-0.115)、个人月平均收入(0.079)，提示社会支持对自我管理行为仅有间接正向效应(β=0.398)，健康素养对自我管理行为有直接(β=0.452，

0.001)和间接正向效应(β=0.081)，自我效能对自我管理行为有直接正向效应(β=0.431，

0.001)。

结论

冠心病患者自我管理行为处于中等偏下水平，基于健康信念模式的冠心病患者自我管理行为模型具有较好的解释和预测作用。

Abstract

Objective

To establish a model of self-management behaviors for patients with coronary atherosclerotic heart disease based on the theory of health belief model and conduct an empirical study to verify the validity and performance of the model.

Methods

We conducted a cross-sectional questionnaire survey among 280 patients with coronary heart disease from 3 general hospitals in Chongqing during the period from November

2017 to April

2018. The general condition questionnaire

social support rating scale

coronary heart disease health literacy questionnaire

chronic disease self-efficacy scale and coronary heart disease self-management scale were used in the survey. The factors in the theoretical model that potentially affected self-management behaviors of the patients were analyzed based on the structural equation model.

Results

Based on 276 valid questionnaires retrieved (98.57%)

the total mean score of self-management behaviors of the patients with coronary heart disease was 81.49±13.83. Correlation analysis revealed that the scores for social support

health literacy and self-efficacy were positively correlated with the scores for self-management (

=0.229

0.499

and 0.341

respectively;

0.001). The structural equation model demonstrated that the model of self-management beha

viors was well fitted in patients with coronary heart disease. The factors affecting self-management behaviors included health literacy (0.533)

self-efficacy (0.431)

social support (0.398)

number of complications (0.257)

education level (0.165)

age (-0.115)

and average monthly personal income (0.079). The model also showed that social support had only an indirect positive effect (β=0.398)

health literacy had both direct (β=0.452

0.001) and indirect positive effects (β=0.081)

and self-efficacy had a direct positive effect on self-management behaviors (β=0.431

0.001).

Conclusion

The patients with coronary heart disease have moderate to low levels of self-management behaviors. The self-management behavior model constructed based on the health belief model has good interpretative and predictive effects in patients with coronary heart disease.

关键词

Keywords

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