PREDICTIVE FACTORS OF SELF-MANAGEMENT BEHAVIORS AMONG PATIENTS WITH CORONARY HEART DISEASE: A STRUCTURAL EQUATION MODELING

Abstract

Self-management behaviors can reduce symptom aggravation, recurrent rate of cardiac events, and improve the quality of life for patients with coronary heart disease. Currently, low levels of self-management behaviors are reported among CHD patients. The purpose of this study was to develop and test a causal model of self-management behaviors among adults with coronary heart disease. A sample of 352 participants was recruited from cardiology in tertiary care hospitals in Yancheng, Jiangsu province, China. Data were collected by self-administered questionnaires including the Demographic record form, the family APGAR index, the Chew’ s set of brief screening questions, the self-rating depression scale, the coronary heart disease knowledge questionnaire, the self-efficacy for chronic disease 6-item scale, the social support rating scale and the coronary artery disease self-management scale. AMOS software program was used to test the model of self-management behaviors.

The results showed that the final model of self-management behaviors consisted of family functioning, health literacy, depression, knowledge, self-efficacy and social support, which explained 57% of the total variance for self-management behaviors (R2 = .57). Health literacy, self-efficacy and social support had a direct effect on self-management behaviors, whereas self-efficacy and social support were mediators between family functioning, depression, knowledge, and self-management behaviors.

These findings suggest that nurses should develop nursing interventions to improve self-management behaviors by reducing depression and promoting family functioning, health literacy, knowledge, self-efficacy and social support.

-