健康信念和医师信任在成年人主动性人格与就医态度间的多重中介作用

The multiple mediating effects of health belief and physician trust on proactive personality and medical attitude in adults

目的探讨主动性人格对就医态度的影响以及健康信念和医师信任的中介作用。方法2019年10~11月,采用主动性人格量表、中国成年人健康信念量表、维克森林医师信任量表和就医态度量表对703名成年人群体进行调查,通过SPSS 23.0进行描述性统计、相关分析,使用SPSS PROCESS 3.3宏程序进行中介效应分析。结果(1)成年人主动性人格得分为(55.12±11.00)分,健康信念得分为(74.88±10.31)分,医师信任得分为(33.23±5.63)分,就医态度得分为(56.55±13.07)分。主动性人格与健康信念(r=0.535)、医师信任(r=0.298)和就医态度(r=0.406)呈显著正相关(均P<0.01),健康信念与医师信任(r=0.363)、就医态度(r=0.696)呈显著正相关(均P<0.01),医师信任与就医态度呈显著正相关(r=0.452,P<0.01)。(2)主动性人格通过三条路径对就医态度产生影响,健康信念的单独中介作用效应值为0.326,占总间接效应的82.74%;医师信任的单独中介作用效应值为0.040,占总间接效应的10.15%;健康信念和医师信任的链式中介作用效应值为0.028,占总间接效应的7.11%。结论健康信念和医师信任在成年人主动性人格和就医态度间起多重中介作用。

Objective To explore the influence of proactive personality on medical attitude and the mediating role of health belief and physician trust.Methods A total of 703 adults were surveyed by proactive personality scale,Chinese adult health belief scale,Wake Forest physician trust scale and medical attitude scale from Octomber to November 2019.Descriptive statistics and correlation analysis were conducted by SPSS 23.0 software,and mediating effects were analyzed by SPSS macro program PROCESS 3.3.Results(1)For all subjects,the score of proactive personality was(55.12±11.00),the score of health belief was(74.88±10.31),the score of doctor trust was(33.23±5.63),and the score of medical attitude was(56.55±13.07).Proactive personality was significantly positively correlated with health belief(r=0.535),physician trust(r=0.298)and medical attitude(r=0.406)(all P<0.01),and health belief was significantly positively correlated with physician trust(r=0.363)and medical attitude(r=0.696)(both P<0.01).There was a significant positive correlation between physician trust and medical attitude(r=0.452,P<0.01).(2)Proactive personality had an impact on medical attitude through three pathways.The single mediating effect value of health belief was 0.326,accounting for 82.74%of the total indirect effect.The single mediating effect value of physician trust was 0.040,accounting for 10.15%of the total indirect effect.The chain mediating effect value of health belief and physician trust was 0.028,accounting for 7.11%of the total indirect effect.Conclusion Health belief and physician trust play multiple mediating roles in proactive personality and medical attitude in adults.