永久性结肠造口患者的自我护理及相关因素：一个结构方程模型

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing Pub Date : 2025-02-13 DOI:10.1016/j.apjon.2025.100666

Longyan Bian , Pornchai Jullamate , Chanandchidadussadee Toonsiri , Poonpong Suksawang

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引用次数: 0

摘要

目的探讨中国永久性结肠造口患者电子健康素养、健康促进行为、抑郁、疾病耻感、自我效能感和自我保健的结构关系。方法于2022年10月至2023年7月进行横断面多阶段随机抽样研究。该研究从中国盐城市的四家综合医院招募了280名永久性结肠造口患者。使用问卷包收集数据以评估模型变量，包括健康促进行为、电子健康素养、抑郁、疾病耻辱感、自我效能感和自我保健。采用结构方程模型对数据进行分析。结果该模型解释了总方差的81.8%。促进健康行为(β = 0.41, P <；0.001)，电子健康素养(β = 0.16, P <；0.001)和抑郁(β = - 0.17, P <；0.001)直接影响自我照顾。另一方面，促进健康行为、抑郁和疾病耻感通过自我效能感间接影响自我保健。在结肠造口患者中，促进健康行为和抑郁对自我护理的总影响、直接影响和间接影响分别为0.53和- 0.26、0.41和- 0.17、0.12和0.09。结论本研究强调了改善结肠造口患者的健康促进行为、电子健康素养和自我效能感的重要性。该研究还表明，减少抑郁和疾病耻辱感可以增强患者的自我保健。卫生保健专业人员可以利用这些发现制定适当的计划来改善患者的自我保健。

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Self-care and associated factors of patients with permanent colostomies: A structural equation model

Objective

To investigate the structural relationships between eHealth literacy, health-promoting behaviors, depression, disease stigma, self-efficacy and self-care in Chinese patients with permanent colostomies.

Methods

A cross-sectional multi-stage random sampling study was conducted between October 2022 and July 2023. The study involved 280 participants with permanent colostomies recruited from four general hospitals in Yancheng City, China. Data were collected using a questionnaire package to assess model variables, including health-promoting behaviors, eHealth literacy, depression, disease stigma, self-efficacy and self-care. Structural equation modeling was employed to analyze the data.

Results

The model explained 81.8% of the total variance. Health-promoting behaviors (β = 0.41, P < 0.001), eHealth literacy (β = 0.16, P < 0.001), and depression (β = −0.17, P < 0.001) inﬂuenced self-care directly. On the other hand, health-promoting behaviors, depression and disease stigma inﬂuenced self-care indirectly through self-efficacy mediation. The total, direct, and indirect effects of health-promoting behaviors and depression on self-care were 0.53 and −0.26, 0.41 and −0.17, and 0.12 and 0.09, respectively, in patients with colostomies.

Conclusions

This study highlights the importance of improving health-promoting behaviors, eHealth literacy, and self-efficacy in patients with colostomies. The study also suggests that reducing depression and disease stigma could enhance patients' self-care. Health care professionals can leverage these findings to develop appropriate programs to improve patients' self-care.

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