The Study Of Self-management Behavioral Influences Among Community Patients With Type 2 Diabetes Based On The Health Promotion Model

Compared with other chronic diseases, the self-management program of diabetes is quite complex and challenging, it also calls for high level of the patients’ self-management ability; On the other hand, the interaction and relationship between the influence factors of diabetes self-management behaviors are very complicated, so this research will introduce Pender’s health promotion model theory and the related methods into the self-management behavior research of patients with type 2 diabetes in order to analysis the impact routine and degree that the influence factors have on the self-management behaviors, so as to set reasonable interventions for diabetes patients, and to provide basis and advice for the best effect of disease management.Objective:(1) To investigate the current situation of personal factors, prior related behavior, perceived benefits of action, perceived barriers to action, perceived self-efficacy, interpersonal influences, situational influences, commitment to a plan of action, and the self-management behavioral outcome among the type 2 diabetes patients. (2) To analyze the self-management influence factors and behavioral outcome among the type 2 diabetes patients with different characteristics. (3) To discuss the impact routine and degree that the influence factors have on the self-management behaviors based on the theory and method of Pender’s health promotion model. (4) To propose decent suggestions and intervention measures to provide the basis for the best effect of disease management.Methods:The sample was selected from four different communities randomly based on the fact that Hangzhou district has established the health management system for the control of chronic diseases in the community and build health records as well as providing tracking interventions at the same time. Descriptive analysis, single factor variance analysis, multiple linear regression and path analysis were used for data analysis.Results:(1) Education, income, complications, perceived health situation and living status influenced the self-management behavioral outcome; Income affected all the self-management influence factors; Education affected all the self-management influence factors expect perceived barriers to action and situational influences; Living status affected all the self-management influence factors expect perceived barriers to action; perceived health situation affected all the self-management influence factors expect interpersonal influences; Marriage affected perceived barriers to action and interpersonal influences. (2) Spearman correlation analysis showed that each self-management influence factor had a positive significance with the behavioral outcome(P<0.01); the correlation coefficient between prior related behavior and behavioral outcome was 0.891. (3) According to the path analysis, the total impact of each self-management influence factor to the behavioral outcome was presented in the following order:perceived self-efficacy (0.628), prior related behavior (0.527), perceived barriers to action (0.179), commitment to a plan of action (0.162), perceived benefits of action (0.159), interpersonal influences (0.101), situational influences (0.025).Conclusion:(1) Education, perceived health status, complications had a strong influence on the glucose monitor, diet, exercise adherence. However, the glucose monitor, diet, exercise adherence situation was not quite optimistic, which needs to be further improved. (2) The personal factors of diabetes patients had a significant correlation with self-management influence factors and behavioral outcome. (3) The total impact of each self-management influence factor to the behavioral outcome was presented in the following order:perceived self-efficacy、prior related behavior、 perceived barriers to action、commitment to a plan of action、perceived benefits of action、interpersonal influences、situational influences; Prior related behavior, interpersonal influences, perceived self-efficacy and commitment to a plan of action had direct influence on behavioral outcome; Perceived benefits of action, perceived barriers to action and situational influences had indirect impact on behavioral outcome; The impact of situational influences and interpersonal influences on behavioral outcome was weak comparatively, and situational influences could influence behavioral outcome through interpersonal influences.