Theory of Planned Behavior and Social Cognitive Theory on the Effect of the Community Health Center Tertiary Preventive Behavior among Patients with Type 2 Diabetes Mellitus: A Multilevel Analysis

Journal of Health Promotion and Behavior Pub Date : 2020-01-16 DOI:10.26911/thejhpb.2020.05.01.08

Yudi Andriyaningtiyas, D. Tamtomo, Bhisma Murti

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引用次数: 1

Abstract

Background: Type 2 diabetes mellitus (DM) accounts for 90% to 95% of all diabetes cases. Complications of type 2 diabetes increase the risk of death for sufferers. Complications and deaths from type 2 diabetes can be prevented by changes in behavior. This study aimed to determine the effect of health centers and other factors on the prevention of tertiary diabetes type 2, using the theory of planned behavior and social cognitive theory. Subjects and Method: This was an analytic observational study with cross sectional design, conducted at 25 community health centers, in Bantul Regency, Yogyakarta, Indonesia. A sample of 200 type 2 DM patients was selected by exhaustive sampling. The dependent variable was type 2 DM tertiary prevention. The independent variables at level 1 are intention, attitude, subjective norm, perceived behavior control/ self-efficacy, experience, modelling, self-regulation, and outcome expectation. Community health center was an independent variable at level 2. The data were collected by questionnaire and analyzed by a multilevel multiple linear regression. Results: Tertiary preventive behavior in type 2 DM patients increased with strong intention (b= 1.19; 95% CI= 0.62 to 1.76; p <0.001), positive attitude (b= 1.19; 95% CI= 0.58 to 1.80; p <0.001), supportive subjective norm (b= 0.79; 95% CI= 0.12 to 1.45; p= 0.019), perceived behavior control (b= 1.16; 95% CI= 0.60 to 1.72; p <0.001), abundant experience (b= 0.65; 95% CI= 0.62 to 1.25; p<0.001), strong modelling (b= 1.07; 95% CI= 0.53 to 1.67; p= 0.030), strong self-regulation (b= 0.87; 95% CI= 0.34 to 1.40; p= 0.001), and positive outcome expectation (b= 0.82; 95% CI= 0.25 to 1.38; p = 0.004). Community health center had contextual effect on the tertiary preventive behavior in type 2 DM patients with ICC= 19.18%. Conclusion: Tertiary preventive behavior in type 2 DM patients increases with strong intention, positive attitude, supportive subjective norm, perceived behavior control, abundant experience, strong modelling, strong self-regulation, and positive outcome expectation. Community health center has contextual effect on the tertiary preventive behavior in type 2 DM patients. Keywords: tertiary prevention behavior, type 2 diabetes, TBP, SCT, multilevel analysis. Correspondence: Yudi Andriyaningtiyas. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta. Email: yudi.andriyaningtiyas@gmail.com. Mobile: +6281392704899 Journal of Health Promotion and Behavior (2020), 05(01): 59-71 https://doi.org/10.26911/thejhpb.2020.05.01.08

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计划行为理论与社会认知理论对2型糖尿病患者社区卫生中心三级预防行为影响的多水平分析

背景:2型糖尿病(DM)占所有糖尿病病例的90% ~ 95%。2型糖尿病的并发症增加了患者的死亡风险。2型糖尿病的并发症和死亡可以通过改变行为来预防。本研究旨在利用计划行为理论和社会认知理论，确定健康中心和其他因素对预防糖尿病的影响。研究对象和方法:这是一项采用横断面设计的分析性全国研究，在印度尼西亚日惹市Bantul Re-gen-cy的25个社区卫生中心进行。采用穷举抽样法选取200例2型糖尿病患者。因变量为2型糖尿病三级预防。水平1的自变量是意图、态度、主观规范、感知行为控制/自我效能、经验、建模、自我调节和结果预期。社区卫生中心是第2级的独立变量。采用问卷调查法收集资料，采用多水平多元线性回归分析。结果:2型糖尿病患者三级预防行为增加且意图强烈(b= 1.19;95% CI= 0.62 ~ 1.76;P <0.001)，积极态度(b= 1.19;95% CI= 0.58 ~ 1.80;P <0.001)，支持性主观规范(b= 0.79;95% CI= 0.12 ~ 1.45;P = 0.019)，感知的行为-行为-控制(b= 1.16;95% CI= 0.60 ~ 1.72;P <0.001)，经验丰富(b= 0.65;95% CI= 0.62 ~ 1.25;P <0.001)，强建模(b= 1.07;95% CI= 0.53 ~ 1.67;P = 0.030)，自我调节能力强(b= 0.87;95% CI= 0.34 ~ 1.40;P = 0.001)，阳性结果预期(b= 0.82;95% CI= 0.25 ~ 1.38;P = 0.004)。社区卫生中心对ICC的2型糖尿病患者三级预防行为有情境影响= 19.18%。结论:2型糖尿病患者三级预防行为以强烈的意向、积极的态度、支持性的主观规范、感知的行为-行为控制、丰富的经验、强的建模、强的自我调节和积极的结果预期增加。社区卫生中心对2型糖尿病患者三级预防行为有情境效应。关键词:三级预防行为，2型糖尿病，TBP, SCT，多水平分析通信:Yudi Andriyaningtiyas。公共卫生硕士课程，西贝拉斯市场大学，jr。红外光谱。苏塔米36A号，泗水。电子邮件:yudi.andriya-ning——tiyas@gmail.com。健康促进与行为杂志(2020)，05(01):59-71 https://doi.org/10.26911/thejhpb.2020.05.01.08

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Journal of Health Promotion and Behavior

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