利用创新特征与健康信念模式分析食物图谱对2型糖尿病患者饮食技能的作用  

Using health belief model and innovative features to analyze the influence of food atlas on the dietary skills of type 2 diabetes patients

作　　者：郭怡 陈平[1] 孙昕霙[1] GUO Yi;CHEN Ping;SUN Xin-ying(School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院,北京100191

出　　处：《中国健康教育》2022年第4期313-317,共5页Chinese Journal of Health Education

基　　金：国家自然科学基金资助项目(2174008)。

摘　　要：目的 结合创新特征与健康信念模式分析食物图谱对社区2型糖尿病患者的饮食技能的影响因素并评估干预效果。方法 在北京市顺义区、通州区下属22个社区卫生站整群抽取符合条件的2型糖尿病患者,以社区中心(站)为单位随机分为对照组与干预组。对照组接受常规护理,直接干预组与间接干预组额外发放自制图谱进行饮食干预。采用方差分析比较各组之间的差异,运用Pearson相关检验、结构方程模型对图谱使用行为进行分析。结果 3个月时,对照组、直接干预组和间接干预组的饮食技能得分均大于基线(P<0.01),提升比例分别为14.9%、38.1%和31.4%,直接干预组与间接干预组饮食技能得分差异无统计意义(P>0.05),但均大于对照组(P<0.01)。模型显示,食物图谱的可观察性可通过影响益处感知(β=0.50)与障碍性感知(β=-0.44)间接作用于患者的利用程度与使用意向,也可直接影响使用意向(β=0.54)与利用程度(β=0.16);饮食技能得分的增加直接受使用意向(β=0.19)、自我效能(β=0.15)、提示因素(β=0.11)与利用程度(β=0.16)影响。结论 食物图谱可以提高2型糖尿病患者的饮食技能,创新特征与健康信念模式整合模型可以解释患者的饮食干预采纳行为。Objective To explore the influence of food atlas on the dietary skills of type 2 diabetes patients in the community, and to apply health belief model and innovative features to analyze the intervention effect and its influencing factors. Methods Eligible type 2 diabetes patients from 22 community health service centers in Shunyi District and Tongzhou District of Beijing were randomly divided into control group and intervention group. The control group received routine nursing, and the direct intervention group and the indirect intervention group received additional self-made atlas for dietary intervention. Variance analysis was used to compare the differences among groups, and Pearson correlation test and structural equation model were used to analyze the mapping behavior. Results At 3 months, the scores of dietary skills in the control group, the direct intervention group and the indirect intervention group were all higher than the baseline(P<0.01),and the improvement rates were 14.9%,38.1% and 31.4%,respectively. There was no statistical difference in dietary skills scores between the direct intervention group and the indirect intervention group(P=0.88),which were all larger than the control group(P<0.01). The structural equation model shows that observability of food atlas can indirectly affect patient′s use by influencing the perception of benefit(β=0.50)and obstacle(β=0.44),and can directly affect the intention(β=0.54)and utilization(β=0.16);dietary skill score is directly influenced by intention(β=0.19),self-efficacy(β=0.15),cues(β=0.11)and the utilization(β=0.16). Conclusion Food atlas can improve the dietary skills of patients with type 2 diabetes, and an integrated model of innovative features and health belief model can explain the dietary intervention adoption of patients.

关 键 词：2型糖尿病 饮食技能 食物图谱 健康信念模式 创新特征 

分 类 号：R193[医药卫生—卫生事业管理]