影響代謝症候群患者行使健康飲食、運動行為的心理社會因素

目的：探討代謝症候群患者行使健康飲食、運動行為的重要預測因子。方法：以「健康信念模式」、「計畫性行為理論」架構問卷、社會支持行為量表、醫病關係問卷為研究工具，執行地點為南部某兩間醫院，執行時間為民國九十九年七月至民國一○○年十月。對象：兩百五十名代謝症候群病患(平均年齡/標準差：55.32歲/10.71)。分析：利用描述性統計、t 檢定、相關分析、迴歸分析、路徑分析來檢核研究變項對健康飲食、運動行為的預測效力。結果：自覺罹病性、自覺健康行為阻礙、行為模範、自我效能感、內控觀，以及社會支持變項能解釋「健康飲食行為意圖」32%的變異量；自覺罹病性、自覺健康行為阻礙、自我效能感、內控觀，以及社會支持變項能解釋「運動行為意圖」46%的變異量。「社會支持」是「健康飲食行為意圖」最強的預測因子(β =.228, p < .01)，而「自我效能感」是「運動行為意圖」最強的預測因子(β =.340, p < .01)。自覺健康行為阻礙、認知規範、行為模範、外控(權力他人)觀、社會支持，以及醫病關係變項能解釋「健康飲食行為」26%的變異量；自覺健康行為阻礙、行為模範、自我效能感，行為意圖變項能解釋「運動行為」58%的變異量。「社會支持」是「健康飲食行為」最強的預測因子(β =.210, p < .01)，而「自我效能感」是「運動行為」最強的預測因子(β =.407, p < .01)。整體而論，「自覺健康行為阻礙」、「社會支持」是「健康行為意圖」的最有效的預測因子，而「自我效能感」是「運動行為」最有效的預測因子。結論與建議：醫療專業人員應提供代謝症候群患者策略與支持，以克服自覺的健康行為阻礙，進而增進病患的自我效能感，增加行使健康行為的機會。

關鍵字

代謝症候群；健康信念模式；計畫性行為理論；自覺健康行為阻礙；自我效能感；社會支持

並列摘要

Objective: To assess predictive factors important to clients with Metabolic Syndrome regarding intention to eat a healthful diet and do exercise within the Theory of Planned Behavior. Design: A survey based on the Health Belief Model and Theory of Planned Behavior in addition of ISSB and a Physician-Patient Relationship questionnaire was administered at two hospitals in southern Taiwan in 2010.07-2011.10. Participants: 250 clients (mean age [SD] age 55.32 [10.71]) with Metabolic Syndrome. Analysis: Descriptive statistics, t test, correlation analysis, regression analysis, and path analysis was used to assess how well the variables of Health Belief Model and the Theory of Planned Behavior predicted behavioral intention to eat a healthful diet and do exercise. Results: Perceived susceptibility, perceived barriers, behavioral models, self-efficacy, internal locus of control, and social support variables accounted for 32% of the variance in behavioral intention to eat a healthful diet; perceived susceptibility, perceived barriers, self-efficacy, internal locus of control, and social support variables accounted for 46% of the variance in behavioral intention to do exercise. Social support had the greatest influence on behavioral intention to eat a healthful diet (β =.228, p < .01), and self-efficacy had the greatest influence on behavioral intention to do exercise (β =.340, p < .01). Perceived barriers, cognitive norms, behavioral models, external (powerful others) locus of control, social support, and physician-patient relationship variables accounted for 26% of the variance in behavior to eat a healthful diet; Perceived barriers, behavioral models, self-efficacy, and behavioral intention variables accounted for 58% of the variance in behavior to do exercise. Social support had the greatest influence on behavior to eat a healthful diet (β =.210, p < .01), and self-efficacy had the greatest influence on behavior to do exercise (β =.407, p < .01). By all accounts, perceived barriers and social support had the biggest impact on intention to health behaviors, and self-efficacy to health behaviors. Conclusions and Implications: Medical professionals must provide strategies and supports for clients with Metabolic Syndrome to conquer the perceived barriers of preventive actions, and therefore improve clients’ self-efficacy to health behaviors.

並列關鍵字

Metabolic Syndrome ； Health Belief Model ； Theory of Planned Behavior ； perceived barriers ； self-efficacy ； social support

參考文獻

Ajzen, I. (1991). The theory of planned behavior. Organizational behavior and human decision processes, 50(2), 179-211. doi: 10.1016/0749-5978(91)90020-t

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