运动自我效能在终末期肾脏病患者运动益处及障碍感知与锻炼意向间的中介效应

Mediating effect of exercise self-efficacy on the relationship between perceived exercise benefits,perceived exercise barriers and exercise intention in patients with end-stage renal disease

目的探讨终末期肾脏病患者运动益处及障碍感知、运动自我效能与锻炼意向的关系,为建立有效的运动康复干预方案提供参考。方法采用一般资料调查表、透析患者感知运动益处及障碍量表、运动自我效能量表及锻炼意向问卷对249例终末期肾脏病患者进行调查。结果终末期肾脏病患者锻炼意向得分为14.0(12.0,14.0)分,运动益处感知为37.0(34.0,39.0)分,运动障碍感知为33.0(30.0,35.0)分,运动自我效能为40.0(36.5,44.0)分。结构方程模型结果显示,运动障碍感知对锻炼意向有直接负向作用(β=-0.230,P<0.05),运动自我效能对锻炼意向有直接正向作用(β=0.246,P<0.05)。运动自我效能在终末期肾脏病患者运动益处感知锻炼意向的影响中发挥完全中介效应,在运动障碍感知对锻炼意向的影响中发挥部分中介效应,贡献率为15.13%。结论运动自我效能在运动益处及障碍感知对终末期肾脏病患者锻炼意向的影响中起中介作用,医护人员应采取措施降低感知到的运动障碍对患者运动意向的影响,帮助其逐步适应运动锻炼并建立自信心,从而使患者有意向参与透析康复锻炼。

Objective To explore the relationships among perceived exercise benefits,perceived exercise barriers,exercise self-efficacy and exercise intention in patients with end-stage renal disease(ESRD),and to provide reference for the establishment of effective exercise rehabilitation intervention programs in clinical practice.Methods A total of 249 patients with ESRD were investigated by using the general information questionnaire,Dialysis Patient-perceived Exercise Benefits and Barriers Scale,Self-efficacy for Exercise Scale,and Exercise Intention Questionnaire.Results The scores of exercise intention of ESRD patients was 14.0(12.0,14.0),the perceived exercise benefits was 37.0(34.0,39.0),the perceived exercise barriers was 33.0(30.0,35.0),and the exercise self-efficacy was 40.0(36.5,44.0);The results of structural equation model showed that the perceived exercise barriers had a direct negative effect on exercise intention(β=-0.230,P<0.05),exercise self-efficacy had a direct positive effect on exercise intention(β=0.246,P<0.05).Exercise self-efficacy played a complete mediating effect in the influence of perceived exercise benefits on exercise intention,and played a partial mediating effect in the influence of perceived exercise barriers on exercise intention,explaining 15.13%of the variability.Conclusion Exercise self-efficacy plays a mediating role in the influence of perceived exercise benefits and barriers on exercise intention in patients with ESRD,and medical staff should take measures to reduce the impact of perceived exercise barriers on patients′exercise intention,help them gradually adapt to exercise and build self-confidence,so that patients have the intention to participate in dialysis rehabilitation exercise.