基于综合转变模型的炎症性肠病患者饮食管理行为阶段现状及其影响因素研究

Investigation on Current Situation of Dietary Behavior and Its Influencing Factors among Patients with Inflammatory Bowel Disease Based on Integrated Change Model

目的基于综合转变模型,分析炎症性肠病患者饮食管理阶段分布现况及其影响因素。方法2020年1-11月便利抽样选取南京市4家综合性医院门诊炎症性肠病患者608例,采用基于综合转变模型设计的调查问卷收集患者的饮食行为阶段、心理弹性、饮食管理自我效能和意愿等。结果46例(7.57%)处于无意图阶段,290例(47.70%)处于意图阶段,272例(44.74%)处于行动阶段。回归分析显示,饮食管理意愿、行动的自我效能、自我管理和病友支持是炎症性肠病患者行为阶段转变的保护因素,积极认知是影响无意图阶段向行动阶段转变的危险因素(均P<0.05)。结论炎症性肠病患者的饮食管理行为仍有待改善,需依据不同行为阶段的关键社会认知特征,为患者设计精准、高效的饮食管理支持方案,从而促进其饮食行为向高阶段转变。

Objective Based on integrated change model(ICM),to investigate the current distribution of stages of dietary behavior among patients with inflammatory bowel disease(IBD)and its related influencing factors.Methods From January to November 2020,convenience sampling method was used to recruit 608 IBD patients from four tertiary hospitals in Nanjing.ICM-based questionnaire was used to collect information on the stage of dietary behavior,resilience,self-efficacy and willingness.Results About 46 patients(7.57%)were in pre-intention stage,290 patients(47.70%)were in intention stage,and 272 patients(44.74%)were in action stage.By multivariate logistic regression analysis,willingness,action self-efficacy,self-management and peer support were protective factors affecting the distribution of stages of dietary behavior,while positive cognition was a risk factor(all P<0.05).Conclusions The dietary behavior of patients with IBD needs to be improved.More attention should be paid to developing accurate and efficient measures of dietary management tailored to patients’behavior stages to promote change of dietary behavior effectively.