Correlation Of Self-care Ability With Illness Perception And Health Behaviors In Patiens With Stable Coronary Heart Disease Based On COM-B Model

Objective:To understand the status of self-care ability,illness perception and health behavior in patients with stable coronary heart disease(SCAD).The influencing factors of self-care ability of patients with SCAD were analyzed,and the COM-B model was used to classify them and propose intervention measures.To clarify the correlation between self-care ability and illness perception and health behavior in patients with SCAD.To explore the mediating effect of illness perception between self-care ability and health behavior,so as to provide reference for improving self-care ability,improving negative disease perception and promoting health behavior of patients with SCAD.Methods:The patients with SCAD in the Department of Cardiology of a tertiary hospital in Hefei were selected as the research object by convenient sampling method.From October 2021 to May 2022,a questionnaire survey was conducted on 294 patients with SCAD who met the inclusion and exclusion criteria.The survey tools included general information questionnaire,Self-Care of Coronary Heart Disease Inventory,Illness Perception Questionnaire,and Health Promoting Lifestyle Profile Ⅱ The general information,self-care ability,illness perception and health behavior of the subjects were described by means of mean and standard deviation and composition ratio.The demographic differences of self-care ability of patients with SCAD were analyzed by t test,one-way analysis of variance and rank sum test.Multiple linear stepwise regression analysis was used to explore the influencing factors of self-care ability.Pearson analysis or Spearman analysis was used to explore the correlation between patients ’self-care ability,illness perception and health behavior.The mediating effect method was used to explore the mediating role of illness perception between self-care ability and health behavior.Results:(1)The scores of self-care ability of patients with SCAD were:self-care maintenance(50.00±12.77)points,self-care management(56.37±14.60)points,and self-care confidence(55.63± 17.11)points,which were at a low level.The scores of positive perception dimension of illness perception in patients with SCAD were lower,and the scores of negative perception dimension were higher.The health behavior score of patients with SCAD was(118.25± 15.96),which was at a general level.(2)The results of multiple linear stepwise regression analysis showed that the factors affecting the maintenance of self-care in patients with SCAD were age,education level,number of stent implantation and number of chronic diseases,which could explain 43.2%of the variation.The influencing factors of self-care management included permanent residence,course of disease,number of stents implanted and cardiac function classification.The regression model could explain 14.5%of the variation.The factors affecting self-care confidence were education level,permanent residence and number of hospitalizations into the regression model,which could explain 12.7%of the variation.(3)The results of correlation analysis showed that the three dimensions of self-care ability were positively correlated with the positive perception dimension of illness perception(P<0.05),negatively correlated with negative perception(P<0.05),and positively correlated with the main dimensions of health behavior(P<0.05).Health behavior was positively correlated with the positive perception dimension of disease perception(P<0.05)and negatively correlated with negative perception(P<0.05).(4)The results of mediating effect analysis showed that self-care maintenance of patients with SCAD had an impact on health behavior through disease consequences and disease consistency,and the mediating effect accounted for 46.11%of the total effect.Self-care management affected health behavior through the consistency of disease course and disease,and the mediating effect accounted for 55.36%of the total effect.Self-care confidence affected health behavior through disease consistency,and the mediating effect accounted for 74.52%of the total effect.Conclusion:(1)The level of self-care ability in patients with SCAD in this study was low,and the scores of self-care maintenance,self-care management and self-care confidence in most patients were<70 points.The health behavior of patients is at a general level,and the positive perception of disease needs to be improved.(2)There is a correlation between self-care ability,illness perception and health behavior in patients with SCAD The three dimensions of self-care ability can not only directly affect the health behavior of patients,but also indirectly affect the health behavior of patients through the course of disease,disease consequences and disease consistency.