The Relationship Between Health Locus Of Control,social Support And Health-promoting Behavior In Patients With Chronic Heart Failure

Objective(1)A cross-sectional survey was conducted on patients with chronic heart failure to understand the current status of their health-promoting behaviors,health locus of control,and social support.(2)To explore the correlation between health-promoting behavior,health locus of control and social support in patients with chronic heart failure,and to further explore the interaction relationship between the three,and construct a structural equation model,in order to provide a theoretical basis for the clinical development of measures to improve the health-promoting behavior level of patients with chronic heart failure.MethodFrom February 2022 ～ December 2022,200 hospitalized patients with chronic heart failure who met the inclusion and exclusion criteria were selected in a tertiary hospital in Dalian City,and the general condition questionnaire,multidimensional health locus of control scale,social support scale and health promotion lifestyle scale-revised version II were selected for cross-sectional investigation.After data entry and collation in Excel,SPSS 26.0 and AMOS 21.0 were imported for statistical analysis and structural equation model construction,using statistical methods such as descriptive analysis,t-test,one-way ANOVA,Pearson correlation analysis,and multiple linear regression analysis.Result1.In this group of chronic heart failure patients,the score of health-promoting behavior was(98.15±17.98),the score of internal control of health locus of control was(22.24±3.71),the score of powerful others control type was(23.93±4.01),the score of chance control type was(15.70±3.85)score,and the score of social support was(35.30±7.5).2.Studies on the relationship between health locus of control,social support and health-promoting behavior in patients with chronic heart failure showed that internal control type and powerful others control type were positively correlated with the level of health-promoting behavior,respectively(r=0.515,p < 0.01),(r=0.255,p < 0.01),The chance control type was negatively correlated with the level of health-promoting behavior(r=-0.494,p < 0.01),that is,the patients whose control type of health locus was inclined to internal control type and powerful others type had a high level of health-promoting behavior,while the patients who were inclined to chance control type had a low level of health-promoting behavior.Internal control and powerful others control were positively correlated with social support(r=0.387,p < 0.01),(r=0.222,p < 0.01),and chance control was negatively correlated with social support(r=-0.418,p < 0.01).That is,the patients whose health locus of control tends to be internal control and powerful others control have a high level of social support,while the patients who tend to be controlled by health chance have a low level of social support.The level of social support was positively correlated with the level of health-promoting behavior(r=0.535,p < 0.01),that is,patients with high level of social support had a good level of health-promoting behavior.3.Univariate analysis showed that age,education level,monthly family income,medical payment,marital status,residence status,work status,self-care ability and NYHA cardiac function grade,which had significant differences in health-promoting behavior score(p < 0.05).Multiple linear regression analysis showed that demographic factors(monthly family income,medical payment mode,work status,self-care ability and NYHA cardiac function classification),health locus of control and total social support were the main influencing factors of health-promoting behavior(p < 0.05),which could explain 57.4% of the variation rate.4.The adaptation degree of AMOS structural equation model: CMIN/DF = 2.139,RMSEA=0.076,NFI=0.908,TLI=0.925,CFI=0.948,IFI=0.949,GFI=0.925,AGFI=0.872,the index fit is good,and the model is acceptable.5.The mediating effect of social support on health locus of control and healthpromoting behavior in patients with chronic heart failure Results: Social support has a partial mediating effect on health locus of control sources(internal control,powerful others control and chance control)and health promoting behaviors,accounting for30.43%,36.97% and 32.57% of the total effect,respectively.Conclusion1.The level of health-promoting behavior of patients with chronic heart failure is general,and demographic factors(monthly family income,medical payment method,work status,self-care ability and NYHA cardiac function grade),health locus of controls and social support are the main influencing factors of health-promoting behavior.Internal control,powerful others control and social support positively predict patients’ healthpromoting behavior,and chance control type negatively predict health-promoting behavior.2.There is a partial mediating effect between social support and health-promoting behavior in patients with chronic heart failure.It is suggested that the clinical staff should take individualized intervention programs to help the patients to enhance their confidence in overcoming the disease,so as to change the types of locus of control that are not conducive to their health,improve the social support,and then improve the level of their health-promoting behavior.