摘要
目的本研究旨在应用健康行动过程取向理论(health action process approach, HAPA)和结构方程模型探究2型糖尿病(type 2 diabetes mellitus, T2DM)患者锻炼行为现状及其影响因素,为今后干预提供参考。方法采用自编HAPA问卷调查北京4个社区卫生服务中心的819例T2DM患者,问卷信度、效度良好。应用结构方程模型分析锻炼行为影响因素及潜在中介效应。结果 53.7%的患者年龄在60岁以上,77.2%的患者锻炼行为阶段处于行动或维持期。结构方程显示HAPA模型可有效解释患者锻炼行为(R;=0.466)。意向受任务自我效能(β=0.645)和结果期待(β=0.153)的影响,意向(β=0.783)和保持自我效能(β=0.177)直接影响计划,计划(β=0.340)和恢复自我效能(β=0.403)直接影响锻炼行为。这一过程中,任务自我效能也可影响保持自我效能(β=0.802),保持自我效能影响恢复自我效能(β=0.450),且意向对恢复自我效能也具有正向影响(β=0.483)。结论当前T2DM患者运动参与度较好,但仍需继续提高。HAPA能较好地解释T2DM患者锻炼行为,促进患者锻炼应从提高自我效能方面进行干预。
Objective The purpose of this study is to use the health action process approach(HAPA) and structural equation model to explore the influencing factors of exercise behavior in patients with type 2 diabetes, and to provide references for future interventions. Methods Totally 819 patients with type 2 diabetes mellitus in four community health service centers in Beijing were investigated using a self-compiled questionnaire. The reliability and validity of the questionnaire were good. The structural equation model was used to analyze the influencing factors and potential mediating effects of exercise behavior. Results 53.7% of patients were over 60 years old, and 77.2% of patients were in the action or maintenance phase of exercise behavior. HAPA can effectively explain the exercise behavior of patients(R;=0.466). Behavioral intentions was affected by task self-efficacy(β=0.645) and result expectation(β=0.153). Behavioral intention(β=0.783) and maintenance self-efficacy(β=0.177) had direct effects on implementation intention, while implementation intention(β=0.340) and restoration of self-efficacy(β=0.403) directly affected exercise behavior. Task self-efficacy also affected Maintenance Self-efficacy(β=0.802). Maintenance self-efficacy affected recovery self-efficacy(β=0.450), and behavioral intentions also had a positive effect on maintenance self-efficacy(β=0.483). Conclusions The exercise status of T2 DM patients is good, but it still needs to be further improved. HAPA can well explain the patients’ exercise behavior. Promoting patients’ exercise should focus on interventions that improve their self-efficacy.
作者
郭怡
孙信
黎泽明
陈平
高敏
陈雪莹
孙昕霙
GUO Yi;SUN Xin;LI Ze-ming;CHEN Ping;GAO Min;CHEN Xue-ying;SUN Xin-ying(Department of Social Medicine and Health Education,School of Public Health,Peking University,Beijing 100191,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2022年第1期56-60,98,共6页
Chinese Journal of Disease Control & Prevention
基金
国家自然科学基金(72174008)。
关键词
HAPA
锻炼
2型糖尿病
自我效能
结构方程模型
Health action process approach
Exercise
Type 2 diabetes mellitus
Self-efficacy
Structural equation model
