自我效能和出院准备度在高血压病患者健康素养与自我管理间的链式中介作用  

Self-efficacy and discharge readiness as a chain mediator interaction between health literacy and selfmanagement in hypertensive patients

作　　者：类美容 张红伟 刘静[1] 延泽萍 栾晓嵘[2] LEI Meirong;ZHANG Hongwei;LIU Jing;YAN Zeping;LUAN Xiaorong(School of Nursing and Rehabilitation,Shandong University,Jinan,250012,China)

机构地区：[1]山东大学护理与康复学院,山东省济南市250012 [2]山东大学齐鲁医院

出　　处：《护理实践与研究》2022年第13期1900-1905,共6页Nursing Practice and Research

基　　金：山东省自然科学基金面上项目(编号:ZR2020MG071)。

摘　　要：目的 探讨自我效能和出院准备度在高血压病患者健康素养与自我管理间的链式中介效应。方法 选取2021年3-8月在山东省某三甲医院心内科就诊的高血压病患者232例,应用慢性病健康素养量表、高血压病自我效能量表、出院准备度量表和高血压病自我管理量表进行问卷调查。结果 高血压病患者健康素养108.81±8.62分,自我效能39.29±2.27分,出院准备度99.74±4.67分,自我管理86.81±5.69分。单因素分析结果显示,学历、职业、居住地、月收入和病程是影响高血压病患者自我管理的因素(P<0.05)。自我管理与健康素养、出院准备度和自我效能呈正相关(P<0.01),健康素养与出院准备度和自我效能呈正相关(P<0.01),自我效能与出院准备度呈正相关(P<0.01)。路径分析显示,自我效能在健康素养和自我管理间起部分中介作用,中介效应量0.129,占总效应的34.8%;出院准备度在健康素养和自我管理间起部分中介作用,中介效应量0.046,占总效应的12.4%;自我效能和出院准备度在健康素养和自我管理间起链式中介作用,中介效应量0.022,占总效应的5.9%。结论 健康素养不但直接对患者的自我管理产生影响,还通过自我效能和出院准备度间接影响患者的自我管理。Objective To investigate the chain mediator effects of self-efficacy and discharge readiness on health literacy and self-management in hypertensive patients. Methods 232 patients with hypertension admitted in the department of cardiology of a Grade Ⅲ hospital in Shandong Province from March to August 2021 were selected to conduct a questionnaire survey by using chronic health literacy scale, hypertension self-e ffi cacy scale,discharge readiness scale and hypertension self-management scale. Results The scores of hypertension patients were 108.81±8.62 points in health literacy, 39.29±2.27 points in self-e ffi cacy, 99.74±4.67 in discharge readiness and 86.81±5.69 points in self-management. Univariate analysis showed that education background, occupation,place of residence, monthly income and disease course were the factors af fecting self-management of hypertension patients(P<0.05). Self-management was positively correlated with health literacy, discharge readiness and selfe ffi cacy(P<0.01). Health literacy was positively correlated with discharge readiness and self-e ffi cacy(P<0.01).There was a positive correlation between self-e ffi cacy and discharge readiness(P<0.01). Path analysis showed that self-e ffi cacy partially mediated the relationship between health literacy and self-management, with a mediating ef fect of 0.129, accounting for 34.8% of the total ef fect. Discharge readiness played a partial mediating role in the relationship between health literacy and self-management, the mediating ef fect was 0.046, accounting for 12.4%of the total ef fect. Self-e ffi cacy and discharge readiness played a chain mediating role between health literacy and self-management, with a mediating ef fect size of 0.022, accounting for 5.9% of the total ef fect. Conclusion Health literacy is not only directly af fects patients’ self-management, but also indirectly af fects patients’ self-management through self-e ffi cacy and discharge readiness.

关 键 词：高血压病 健康素养 出院准备度 自我效能 自我管理 中介效应 

分 类 号：R473.54[医药卫生—护理学]