授权及计划行为理论对糖尿病自我管理核心行为预测效果的研究

Prediction of core behaviors of self⁃management in diabetes mellitus by empowerment and theory of planned behavior

目的 探讨授权和计划行为理论(TPB)对T2DM自我管理4项核心行为的预测效果,并分析TPB模型和行为意图对行为的影响路径.方法 选取2022年12月至2023年5月于不同省份3家三级甲等综合医院内分泌科治疗的T2DM患者500例.采用分层回归探讨授权和TPB模型对行为的预测效果,Bootstrap法分析TPB模型和行为意图对行为的影响路径.结果 授权对行为具有预测作用,加入TPB后预测效果提升,分别为用药R^(2)=0.194,监测血糖R^(2)=0.308,饮食R^(2)=0.337,运动R^(2)=0.343.中介效应分析显示,行为态度、主观规范和感知控制均可预测行为意图,且三者除通过行为意图间接影响行为外,还直接影响行为.结论 授权可预测行为,在此基础上加入TPB可提升预测效果.行为态度、主观规范和感知控制通过行为意图间接影响行为,也可直接影响行为.

Objective To explore the predictive effect of empowerment and theory of planned behavior(TPB)on the four core behaviors of type 2 diabetes mellitus(T2DM)self‑management,and analyze the influence path of TPB model and behavioral intention on the four core behaviors.Methods A total of 500 T2DM patients who were hospitalized in the Endocrinology Department of three tertiary general hospitals in different provinces from December 2022 to May 2023 were selected for investigation.Hierarchical multiple regression analysis was used to explore the predictive effects of empowerment and TPB models on self‑management behaviors.Bootstrap method was used to analyze the influence path of TPB model and behavior intention on self‑management behaviors.Results Empowerment had a predictive effect on self‑management behavior,which was improved after the addition of TPB,with medication R^(2)=0.194,blood glucose monitoring R^(2)=0.308,regular diet R^(2)=0.337 and regular exercise R^(2)=0.343,respectively.Mediation effect analyses revealed that attitude,subjective norm,and perceived behavioral control were observed to predict behavior intention across the four behaviors,and the three except through the behavior intention indirectly affect behavior,can also directly affect the behavior.Conclusions Empowerment can predict self‑management behavior,and adding TPB to this can improve the prediction effect.Attitude,subjective norms and perceived control can indirectly or directly affect self‑management behavior through behavioral intention.