| Objectives To describe the prevalence of cognition and behavior about chronic kidney disease(CKD)among adults in Gansu Province;to explore the direct and indirect relationships between the cognition and the behavior in different dimensions,as well as influencing factors;and to analyze the commonalities and characteristics of the relationship between cognition and behavior of CKD between the two different groups of adult residents and college students;in order to provide people with scientific basis for improvement of CKD health literacy and the precise intervention.Methods The face-to-face questionnaire surveys were used to collected data on CKD cognition and behaviors of adult in Gansu Province.The correlation analysis was used to explore the relationship among the main demographic characteristics,family disease history,personal disease history,CKD knowledge,and behavior of the study subjects.Factor analysis was applied to build different dimensions based on multiple elements of CKD cognitive and behavioral.The direct or indirect relationship between cognition and behavior in different dimensions were further discussed through path analysis.Results 1.Among the CKD epidemiological risk factors,college students had higher rates of awareness on drug abuse,prolonged urine retention,and alcohol consumption,which were 73.29%,71.58%,and 69.60%,respectively.Adult residents had a higher awareness rate of drinking,which was 53.31%.For the common clinical causes of CKD,college students had higher rate of awareness of diabetes and CKD family history,which were 59.56% and 54.10%,respectively.Adult residents had higher awareness rates of diabetes and hypertension,which were 51.32% and 49.99%,respectively.Compared to the other symptoms of CKD,hematuria was the most understood one by college students with a cognitive rate of 50.27%;Eyelid edema was the most understood one by adult residents with a cognitive rate of 47.55%.In terms of CKD disease classification,41.87% of university students and 42.81% of adult residents did not know whether CKD is an infectious disease,49.66% of university students and 45.40% of adult residents did not know if CKD is a genetic disease.For the health management of CKD,29.03% of college students and 47.87% of adult residents did not know the correct way of ingesting protein;18.71% of college students and 44.41% of adult residents did not know the correct way of physical exercise.2.For the good habit of“to drink water whether one is thirsty or not”,the habit of “early rest early sleep”,“urine examination every year” and “kidney related medical examinations”,the behavioral rates conducted by college students were40.10%,10.31%,10.59%,and 9.08%,respectively.And the same behavioral rates conducted by adult residents were 27.08%,13.59%,14.98%,and12.57% respectively.In the behaviors of adverse urinary habits,abuse of antipyretic analgesics,and random use of antibiotics,the behavioral rates of college students were 36.54%,18.92%,and 14.34%,respectively.The same behavioral rates of adult residents were 22.75%,23.91%,and 34.80%,respectively.3.Three common factors of CKD cognition were obtained by factor analysis: named as cognitive factors of CKD etiology and symptoms,cognitive factor of basic types of CKD disease,and cognitive factor of health management of CKD patients,respectively.In the same way,four common factors of CKD behavior were got: named as kidney health maintenance behavior factor,diet behavior factor,kidney clinical health care behavior factor,and kidney health hazard behavior factor,respectively.4.In the CKD cognitive and behavioral path model of college students,the regression coefficients of all paths were statistically significant(P<0.05).The model fitting evaluation index NFI,IFI,TLI and CFI were all greater than 0.9,RMSEA=0.021.The standardized effects of gender on cognition of etiology and symptoms of CKD and dietary behavior were: 0.112,0.304,respectively.The normalized effect of family disease history on cognition of etiology and symptoms of CKD and health-harm behaviors were 0.077 and-0.080,respectively.Meanwhile,gender and family history of chronic diseases indirectly affect the behavior of kidney health maintenance and renal clinical health care behavior through the cognition of the three dimensions of CKD.5.In the CKD cognition and behavioral path model of adult residents,the regression coefficients of all paths were statistically significant(P<0.05).The model fitting evaluation index NFI,RFI,IFI,TLI and CFI were all close to 0.9,RMSEA=0.059.The standardized regression coefficients of nationality,education level,cognition of CKD etiology and symptoms,and CKD disease type cognition on self-health management of patients with nephropathy were-0.261,0.249,0.356,and-0.655,respectively.Family history of chronic diseases,personal disease history,and monthly income per capita all indirectly affect the behaviors of CKD from four dimensions through different cognitive pathways.Conclusions 1.Adults in Gansu Province had low levels of correct cognition and healthy behaviors of CKD,especially in healthy behaviors on CKD,the correct behavioral rates among college students and adult residents were prominently uneven.2.In the two different adult groups,cognition and behavior showed complex relationships in different dimensions.The improvement of CKD health literacy and its precise intervention strategies for college students,especially boys,were need to strengthen the basic knowledge of CKD disease and to focus on the implementation on interventions of kidney health care activities,diet,and the habit of urinating;For adult residents,especially ethnic minorities and those with a low level of education,it is necessary to strengthen health education related CKD epidemiological risk factors,clinical etiology and disease management knowledge,and to conduct behavioral interventions focusing on the implementation of scientific drinking water,physical exercise,and rational drug use. |
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