To benefit from a Coronary Artery Bypass Graft Surgery (CABG), patients must adhere to their therapeutic regimen. To test the extent of which the Information-Motivation-Behavioral Skills (IMB) model constructs explain...To benefit from a Coronary Artery Bypass Graft Surgery (CABG), patients must adhere to their therapeutic regimen. To test the extent of which the Information-Motivation-Behavioral Skills (IMB) model constructs explain the variability in adherence behaviors in CABG patients, and also to examine the relationship between the IMB model constructs, CABG patients (N = 152) were randomly assigned to either an intervention group, or a standard care control group. They completed pretest measures, and were reassessed later. Although perfect replication of the IMB model’s predicted pathways was not achieved in this study, support for several of these pathways was demonstrated. The estimated model for adherence-demonstrated good fit of the data. Motivation was a significant predictor of adherence behavior in CABG patients. These findings suggest that IMB model-based intervention that improves motivation can enhance adherence. Therefore, CABG patients’ education programs should mainly target motivation in order to affect adherence behavior.展开更多
Background： The self-consciousness and practicality of preferentially prescribed essential medicines （EMs） are not high enough in county hospitals. The purposes of this study were to use the information-motivation-...Background： The self-consciousness and practicality of preferentially prescribed essential medicines （EMs） are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills （IM B） model to identify the predictors of essential medicines prescribing behavior （EMPB） among doctors and to examine the association between demographic variables, IMB, and EMPB. Methods： A cross-sectional study was carried out to assess predictive relationships among demographic variables and IM B model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the I MB model to test the instruments using analysis of moment structures 17.0. Results： A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old （range： 22-67 years old）. The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 a： 7.34 （hundred mark system： 75.77） and 19.92 ± 3.44 （hundred mark system： 79.68）, respectively. Approximately half（50.8%） of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data （x^2/df= 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066）. More work experience （β = 0.153, P 〈 0.001 ） and behavioral skills （β = 0.449, P 〈 0.001 ） predicted more EMPB. Higher income predicted less information （β = -0.197, P 〈 0.001） and motivation （β =0.204, P 〈 0.001 ）. Behavioral skills were positively predicted by information （β = 0.135, P 〈 0.001 ） and motivation （β = 0.742, P 〈 0.001 ）. Conclusion： The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The influence of demographic variables, such as income and work experience, on EMPB should be fully appreciated. Comprehensive intervention measures should be implemented from multiple perspectives.展开更多
文摘To benefit from a Coronary Artery Bypass Graft Surgery (CABG), patients must adhere to their therapeutic regimen. To test the extent of which the Information-Motivation-Behavioral Skills (IMB) model constructs explain the variability in adherence behaviors in CABG patients, and also to examine the relationship between the IMB model constructs, CABG patients (N = 152) were randomly assigned to either an intervention group, or a standard care control group. They completed pretest measures, and were reassessed later. Although perfect replication of the IMB model’s predicted pathways was not achieved in this study, support for several of these pathways was demonstrated. The estimated model for adherence-demonstrated good fit of the data. Motivation was a significant predictor of adherence behavior in CABG patients. These findings suggest that IMB model-based intervention that improves motivation can enhance adherence. Therefore, CABG patients’ education programs should mainly target motivation in order to affect adherence behavior.
基金This research was supported by grants from Anhui Provincial Natural Science Foundation （No. 1408085MG143）, Anhui Provincial Natural Science Research Project in Universities, Anhui Education Department （No. K J2013A162）, and National Natural Science Foundation of China （No. 71473003）.Acknowledgment We would like to acknowledge the sampled hospitals, participants, team members, and undergraduates of the School of Health Services Management, Anhui Medical University for their support of and contributions to this research.
文摘Background： The self-consciousness and practicality of preferentially prescribed essential medicines （EMs） are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills （IM B） model to identify the predictors of essential medicines prescribing behavior （EMPB） among doctors and to examine the association between demographic variables, IMB, and EMPB. Methods： A cross-sectional study was carried out to assess predictive relationships among demographic variables and IM B model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the I MB model to test the instruments using analysis of moment structures 17.0. Results： A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old （range： 22-67 years old）. The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 a： 7.34 （hundred mark system： 75.77） and 19.92 ± 3.44 （hundred mark system： 79.68）, respectively. Approximately half（50.8%） of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data （x^2/df= 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066）. More work experience （β = 0.153, P 〈 0.001 ） and behavioral skills （β = 0.449, P 〈 0.001 ） predicted more EMPB. Higher income predicted less information （β = -0.197, P 〈 0.001） and motivation （β =0.204, P 〈 0.001 ）. Behavioral skills were positively predicted by information （β = 0.135, P 〈 0.001 ） and motivation （β = 0.742, P 〈 0.001 ）. Conclusion： The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The influence of demographic variables, such as income and work experience, on EMPB should be fully appreciated. Comprehensive intervention measures should be implemented from multiple perspectives.
