摘要目的 检验基于健康信念模式和计划行为理论的中年脑卒中患者自我管理行为的理论整合模型.方法 采用自行设计的一般资料问卷、自我管理行为认知与态度问卷、自我管理行为量表对青岛市3所三级甲等医院神经内科病房住院的654例首发中年脑卒中患者进行调查,用结构方程分析中年脑卒中患者自我管理行为的影响因素.结果 理论整合模型中各理论维度题目标准化因子负荷为0.51～0.91(0.72 ± 0.11);行为意向对自我管理行为有直接正向预测作用,其效应值为0.49(t﹦7.41,P＜0.01);知觉行为控制对自我管理行为既有直接正向预测作用,又可以通过行为意向间接影响自我管理行为,其效应值分别为0.12(t﹦2.75,P＜0.05)、0.04(t﹦2.18,P＜0.05);行为态度通过行为意向对自我管理行为产生影响,其效应值为0.40(t﹦14.71,P＜0.01);主观规范既通过行为意向对自我管理行为产生影响,又通过行为态度间接影响行为意向进而影响自我管理行为,其效应值为0.25;益处感、严重感对自我管理行为的效应值分别为0.21、0.04;该理论整合模型可以解释自我管理行为方差变异的62%.结论 基于健康信念模式和计划行为理论的中年脑卒中患者自我管理行为的理论整合模型可以更好地解释行为,该模型可以尝试应用于脑卒中患者,为脑卒中患者制定个性化护理措施提供了理论依据.

abstractsObjective To examine the integrated model of self-management behavior in middle-aged stroke patients based on health belief model and planned behavior theory. Methods A self- designed general information questionnaire, self- management behavior cognition and attitude questionnaire and self-management behavior scale, were used to investigate 654 cases of first middle-aged stroke patients in the neurology department of 3 grade a hospitals in Qingdao. Results The standardization factor load of each theoretical dimension in the theoretical integration model was 0.51-0.91 (0.72±0.11). Behavioral intention had a direct positive predictive effect on self-management behavior, with an effect value of 0.49 (t=7.41, P<0.01). Perceived behavior control not only had a direct positive prediction effect on self-management behavior, but also indirectly influenced self-management behavior through behavioral intention. The effect values are 0.12 (t=2.75, P<0.05) and 0.04 (t=2.18, P<0.05), respectively. Behavioral attitude exerts influence on self- management behavior through behavioral intention, and the effect value is 0.40 (t = 14.71, P < 0.01). Subjective norms not only influenced self-management behavior through behavioral intention, but also indirectly influenced behavioral intention and self-management behavior through behavioral attitude, with the effect value of 0.25. The effects of perceived benefits and perceived severity on self-management behaviors were 0.21 and 0.04, respectively. The theoretical integration model can explain 62% variance variation of self-management behavior. Conclusion The theoretical integration model of self-management behavior of middle-aged stroke patients based on the health belief model and planned behavior theory can better explain the behavior. This model can be applied to stroke patients in an attempt to provide theoretical basis for the formulation of personalized nursing measures for stroke patients.