Study On The Influencing Factors Of Health Promotion Behavior In Intestinal Stoma Patients Based On Integrated Model Of Health Behavior Theory

ObjectiveTo develop questionnaires to measure the motivation and intention for intestinal stoma patients’health promotion behaviors and test its reliability and validity based on the integration model of Self-Determination Theory and Theory of Planned Behavior.The questionnaire was designed to provide an evaluation tool for investigating the status and influencing factors of health promotion behavior in intestinal stoma patients.Based on the integration model to establish structural equation models of influencing factors of health promotion behavior in intestinal stoma patients.To explore the effects of various factors in the model on health promotion behavior.Methods1.Item pool was formed by literature review method,and the motivation and intention questionnaire for intestinal stoma patients’health promotion behaviors were initially formed by expert letter consultation and small sample tests.215 intestinal stoma patients were selected from December 2020 to March 2021.The questionnaire is tested by item analysis,reliability and validity test,and confirmatory factor analysis.2.270 intestinal stoma patients selected by convenience sampling and from April to July 2021.The investigation of motivation,attitude,subjective norm,perceived behavioral control,behavior intention and health promotion behaviors for intestinal stoma patients using general information questionnaire,Motivation Questionnaire for Intestinal Stoma Patients’Health Promotion Behaviors,Intention Questionnaire for Intestinal Stoma Patients’Health Promotion Behaviors,Health Promoting Lifestyle Profile.The data were analyzed using SPSS 24.0 and AMOS 24.0 software.The measurement data are described by means and standard deviations.According to the type of demographic data,independent sample t test or one-way ANOVA was used to analyze the influencing factors of health promotion behavior in intestinal stoma patients.Pearson correlation analysis was used to analyze the relationship between motivation,Theory of Planned Behavior variables and health promotion behaviors in intestinal stoma patients.Structural equation model was used to analyze the influence path of motivation,attitude,subjective norm,perceived behavior control and behavior intention on health promotion behaviors of intestinal stoma patients.Results1.Questionnaire preparation and reliability and validity test(1)The reliability and validity of the motivation questionnaire for intestinal stoma patients’health promotion behaviors:a total of 4 factors were extracted from the questionnaire,the four factors were named as external regulation,introjected regulation,identified regulation and intrinsic regulation,and the cumulative variance contribution rate was 85.941%,the Cronbach’sαcoefficient of the total questionnaire was 0.802,and the Cronbach’sαcoefficients of each factor were 0.911,0.854,0.930,0.946;The test-retest reliability of the total questionnaire was 0.791,the test-retest reliability of each factor was 0.829,0.723,0.846,0.855;the total content validity of the questionnaire was0.979;the confirmatory factor analysis model fitted well:χ~2/df~2/df=2.175,RMSEA=0.068,GFI=0.938,NFI=0.963,IFI=0.979,TLI=0.972,CFI=0.979.(2)The reliability and validity of the intention questionnaire for intestinal stoma patients’health promotion behaviors:a total of 4 factors were extracted from the questionnaire,the four factors were named as attitude,subjective norm,perceived behavioral control,behavior intention,and the cumulative variance contribution rate was83.166%,the Cronbach’sαcoefficient of the total questionnaire was 0.921,and the Cronbach’sαcoefficients of each factor were 0.917,0.910,0.905,0.945;The test-retest reliability of the total questionnaire was 0.848,the test-retest reliability of each factor was0.883,0.970,0.863,0.880;the total content validity of the questionnaire was 0.983;the confirmatory factor analysis model fitted well:χ~2/df~2/df=1.643,RMSEA=0.050,GFI=0.934,NFI=0.964,IFI=0.986,TLI=0.982,CFI=0.986.2.The health promotion behaviors score in intestinal stoma patients was(124.95±14.75)points,which was in the general level.The differences of health promotion behaviors of intestinal stoma patients in age,educational level,marital status,income and enterostomy time were statistically significant(P<0.05).Motivation,Theory of Planned Behavior variables and health promotion behavior were all positively correlated(P<0.01).3.Structural equation model showed that the total effects of health promotion behaviors autonomous motivation on behaviors was 0.579,and there were four influencing paths:(1)Autonomous motivation can directly affect the health promotion behavior of patients with enterostomy,the direct effect was 0.251,accounting for 43.35%of the total effect;(2)perceived behavioral control was the mediating variable between autonomous motivation and health promotion behavior,and the indirect effect was 0.177,accounting for 30.57%of the total effect;(3)perceived behavioral control and intention were played the chain mediating effect between autonomous motivation and health promotion behavior,and the indirect effect was 0.076,accounting for 13.13%of the total effect;(4)attitude and intention were played the chain mediating effect between autonomous motivation and health promotion behavior,and the indirect effect was 0.041,accounting for 7.08%of the total effect;(5)subjective norm and intention were played the chain mediating effect between autonomous motivation and health promotion behavior,and the indirect effect was 0.034,accounting for 5.87%of the total effect.Conclusions1.The motivation and intention questionnaires for intestinal stoma patients’health promotion behaviors had good reliability and validity.2.The health promotion behaviors of intestinal stoma patients were at the average level.The influencing factors of health promotion behavior in intestinal stoma patients were age,educational level,marital status,income and enterostomy time.There were significant positive correlations between health promotion behavior motivation,variables in the Theory of Planned Behavior and health promotion behavior.3.Based on the integration model of Self-Determination Theory and Theory of Planned Behavior,the structural equation model of influencing factors of health promotion behavior in intestinal stoma patients can explain health promotion behavior better.Health promotion behavior autonomous motivation can directly affect health promotion behavior,or indirectly affect health promotion behavior through attitude,subjective norms and perceived behavior control.