Using The Integrated Theory Of Health Behavior To Investigate The Self-management Behavior Among Middle-aged Patients With Stroke

ObjectiveTo investigate self-management behavior of middle-aged patients with stroke,and to explore the influencing factors of self-management behavior based on a new model of Health Belief Model combined with Theory of Planned Behavior,thereby providing reference to improve patient's self-management ability.MethodsThrough the use of convenient sampling method,a total of 412 middle-aged patients with stroke who have been treated in the department of neurology were enrolled in this study from January 2017 to October 2017 in Qingdao,in there tertiary a hospital.Using self-designed general information questionnaire,cognition and attitude of self-management behavior questionnaire(including behavioral attitude,perceived benefits,perceived barriers,perceived seriousness,perceived susceptibility,normative belief,motivation,perceived behavioral control,behavioral intention)based on a new model of Health Belief Model combined with Theory of Planned Behavior,and adopt Self-management Scale compiled by wang yanjiao.All data were analyzed by SPSS version 17.0 and LISREL version 8.80.The method of confirmatory factor analysis was used to to test the rationality of the structure validity of cognition and attitude of self-management behavior questionnaire.Descriptive statistical methods were used to explore the personal characteristics,cognition and attitude of self-management behavior and self-management behavior.Multiple linear regression analysis was used to analyze the personal characteristics and cognition and attitude of self-management behavior.Pearson correlation analysis was used to analyze the correlation between cognition and attitude of self-management behavior and self-management behavior.Structural equation model was used to analyze the impact of cognition and attitude of self-management behavior on self-management behavior,and to explore the influencing factors of self-management behavior of middle-aged patients with stroke.Results1.Cognition and attitude of self-management behavior questionnaire has good content validity and structure validity,Cronbach's alpha coefficient of total questionnaire was 0.888,Cronbach's alpha coefficient of each questionnaire ranged from 0.600 to 0.798.2.The results of multiple linear regression analysis suggested that education level and family average monthly income was the impact of cognition and attitude of self-management behavior of middle-aged patients with stroke.3.The average score of self-management behavior of middle-aged patients with stroke was 2.88±0.43,and the average score of each dimension from low to high were as follows:disease management,rehabilitation management,daily life management,emotion management,social function and interpersonal management,dietary management and drug safety administration.4.The results of structural equation model shows that a new model of Health Belief Model combined with Theory of Planned Behavior could account for 62% of the variance in self-management behavior of middle-aged patients with stroke.5.The total effect value of behavioral intention to self-management behavior was 0.68,in which the direct effect value was 0.68;the total effect value of perceived behavioral control to self-management behavior was 0.25,in which the direct effect and the indirect effect values were 0.17 and 0.08;the total effect values of behavioral attitude,perceived susceptibility,perceived benefits,perceived barriers,perceived seriousness and subjective norm to self-management behavior were 0.59,0.44,0.26,-0.11,-0.09 and 0.05.6.The total effect value of behavioral attitude to behavioral intention was 0.87,in which the direct effect value was 0.87,The total effect value of perceived behavioral control to behavioral intention was 0.12,in which the direct effect value was 0.12,the total effect values of perceived susceptibility,perceived benefits,perceived barriers,perceived seriousness and subjective norm to behavioral intention were 0.64,0.38,-0.16,-0.13 and 0.08,in which the direct effect values were 0.64,0.38,-0.16,-0.13 and 0.08.7.The total effect value of perceived susceptibility to behavioral attitude was 0.74,in which the direct effect value was 0.74,the total effect values of perceived benefits,perceived barriers,perceived seriousness and subjective norm to behavioral attitude were 0.44,-0.18,-0.15 and 0.09.ConclusionResult of this study indicates that self-management behavior of middle-aged patients with stroke is below the middle level,and the overall level need to be improved.A new model of Health Belief Model combined with Theory of Planned Behaviorl had strong explanatory and predictive ability on self-management behavior among middle-aged patients with stroke.Self-management behavior were directly affected by behavioral intention,perceived behavioral control,and behavioral intention was the key factor.Perceived susceptibilty,perceived benefits,perceived barriers,perceived seriousness,subjective norm,behavioral attitude,perceived behavioral control have indirect effect on behavior through behavioral intention.Education level and family average monthly income have indirect effect on behavior through the cognition and attitude of self-management behavior of middle-aged patients with stroke.