Study On Hypertensive Health Behavior Based On KAB Model

ObjectiveTo investigate the current status of knowledge,behavior and self-efficacy of hypertension patients,and to explore the mediating and moderating role of self-efficacy between knowledge and behavior,so as to provide theoretical basis for effective health education of hypertension and scientific basis for the formulation of hypertension-related behavioral intervention measures.MethodsFrom November 2018 to August 2019,304 hypertensive inpatients in the department of cardiology of 1 tertiary general hospital in Jinan,Shandong province,were selected by convenience sampling.The research instruments included the general information questionnaires,the disease-related questionnaires,questionnaires of Knowledge-Attitude-Behavior related to Hypertension and Self-efficacy Scale of Hypertensive Patients.SPSS 22.0 software was used for descriptive analysis,t-test,variance analysis,multivariate linear regression and the Johnson-Neyman technique.The bias-corrected non-parametric percentile Bootstrap method in PROCESS plug-in was utilized to examine the mediating effect of self-efficacy between knowledge and behavior.Results1.General demographic data and disease-related data of patients with hypertensionA total of 304 subjects were included in this study.Their age varied from 23 to 89 years.Among them,184 cases(60.5%)were male,299 cases(98.4%)were married,88 cases(28.9%)had a junior high school education,232 cases(76.3%)were overweight and obese and 184 cases(60.6%)had medical expenses covered by medical insurance.174 cases(57.2%)had a family history of high blood pressure.173 cases(56.9%)whose frequency of hypotensive drug use was once a day.The number of patients who had sphygmomanometer at home was 265 cases(87.2%).2.Status of knowledge,attitude,behavior and self-efficacy in hypertensive patientsIn this study,the mean score of hypertension-related knowledge was 7.06±2.73,the mean score of hypertension-related attitude was 4.40±1.14,and the mean score of hypertension-related behavior was 24.93±4.08.The score of self-efficacy was 34.10±6.04,9.97±2.67 for medication behavior self-efficacy,7.33±1.32 for tobacco and alcohol management self-efficacy,9.07±2.06 for diet and exercise self-efficacy,and 7.74±2.57 for self-care behavior self-efficacy.3.Knowledge,Attitude and Behavior score of patients with hypertension and their analysis with sociodemographic factors and disease-related factorsHypertension-related behavior scores were significantly different in grouping on gender,occupation,family history of stroke,frequency of medication,and whether or not there was sphygmomanometer(P<0.05).Among them,the score of hypertension-related behavior is higher in women(t=8.798,P<0.001);the score of hypertension-related behavior is higher in the retired(F=5.387,P=0.001);the score of hypertension-related behavior is higher in patients with a family history of stroke(t=1.977,P=0.049);the score of hypertension-related behavior is higher in patients who was taking blood pressure medication for twice a day(F=3.902,P=0.004);the score of hypertension-related behavior is higher in patients whose home have sphygmomanometer(t=3.432,P=0.001).There was no significant differences in scores of hypertension-related behaviors in other demographic and sociological data and other disease data(P>0.05).4.Correlation Analysis of Knowledge,Attitude,Behavior and Self-efficacy in Patients with HypertensionPearson correlation analysis showed that the score of hypertension-related behavior was significantly correlated with hypertension-related knowledge and self-efficacy in patients with hypertension.Among them,hypertension-related behavior was positively correlated with hypertension-related knowledge(r=0.158,P<0.01)and positively correlated with self-efficacy(r=0.346,P<0.01).What's more,hypertension-related knowledge was positively correlated with hypertension-related attitude(r=0.601,P<0.01)and self-efficacy(r=0.448,P<0.01).In addition,hypertension-related attitude was positively correlated with self-efficacy(r=0.263,P<0.01).5.The mediating effect of self-efficacy between hypertension-related knowledge and hypertension-related behaviorThe results of multivariate linear regression analysis showed that hypertension-related knowledge was positively correlated with self-efficacy(?=0.922,P<0.001).Hypertension-related knowledge was significantly associated with hypertension-related behavior(?=0.268,P<0.001).With the inclusion of self-efficacy,the effect of hypertension-related knowledge on hypertension-related behavior was reduced and no longer significant(?=0.099,P>0.05),while self-efficacy was positively correlated with hypertension-related behavior(?=0.183,P<0.001).Further Bootstrap test showed that the 95%confidence interval of self-efficacy mediation effect was[0.098,0.261],excluding 0,suggesting that self-efficacy completely mediated the association of hypertension-related knowledge and hypertension-related behavior.Hypertension-related knowledge indirectly predicted hypertension-related behavior through the mediating role of self-efficacy.The effect was ?=0.169(0.922*0.183),and the mediating effect was 63.1%(0.169/0.268).6.The moderating effect of self-efficacy on hypertension-related knowledge and hypertension-related behaviorThe results of multivariate linear regression analysis showed that self-efficacy moderated the association between.hypertension-related knowledge and hypertension-related behavior(hypertension-related knowledge × self-efficacy:?-3.802,P<0.01).Conclusions1.In this study,the general level of knowledge,attitude,behavior of hypertensive patients is relatively good.Due to lack of a unified hypertension-related knowledge-attitude-behavior scale to evaluate the level of knowledge,attitude,behavior of hypertensive patients,we can not make comparisons with the results of similar studies directly.2.Hypertension-related knowledge is positively correlated with hypertension-related attitude and hypertension-related behavior,while the association between hypertension-related attitude and hypertension-related behavior is not significant.3.Hypertension-related knowledge can enhance hypertension-related behavior through self-efficacy,and self-efficacy plays a completely mediating role between the hypertension-related knowledge and hypertension-related behavior;self-efficacy can moderate the relationship between hypertension-related knowledge and hypertension-related behavior.