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论文编号：	13172
作者编号：	2120202898
上传时间：	2022/6/7 9:48:13
中文题目：	健康信息对慢性病患者健康行为改变的作用机制研究
英文题目：	Impact of Health Information on Health-related Behavior Change of Patients with Chronic Disease
指导老师：	李月琳
中文关键字：	健康行为改变；健康信息；慢性病；健康决策；作用机制
英文关键字：	Health behavior change, health information, chronic disease, health decision, mechanism of action
中文摘要：	健康是个人和社会经济发展的必要条件，慢性病因其病因复杂，且病程长、并发症多，很少能被完全治愈，严重损害了居民健康。我国慢性病患者基数在不断扩大，疾病防控工作仍面临着巨大挑战。信息是影响主体的信念态度，进而影响其行为的重要因素。因此向慢性病患者提供疾病护理、治疗、心理健康等方面的健康信息服务是改进患者健康行为、改善健康状况的重要手段。以往对于健康信息行为的研究大多集中于患者的健康信息需求、搜寻行为特点、影响因素等方面，较少关注患者在获取健康信息后如何利用健康信息改变其健康行为、健康信息对健康行为改变发挥何种作用等。 本研究采用质性研究与定量研究相结合的方法，探讨健康信息对慢性病患者健康行为改变的作用机制，构建并检验健康信息对健康行为改变作用机制模型。首先，研究者采用半结构化深度访谈收集质性数据，以糖尿病患者为研究样本，共招募15名受访者。本研究采用开放式编码的方法对质性数据进行编码分析，构建出健康信息对健康行为改变作用机制的理论模型。该模型以跨理论模型为基础，揭示了患者健康行为改变的阶段以及各阶段的信息源、信息内容及信息发挥的作用，并揭示了患者采纳不同信息源的健康信息的影响因素以及进一步做出健康行为改变的因素。随后本研究采用问卷调查法对上述理论模型中的健康信息采纳部分进行检验，问卷共回收219份，有效问卷205份。模型验证采用分层回归分析法，分别对采纳医生提供的信息、采纳网络信息、采纳电视信息、采纳人际信息、采纳纸质信息和采纳个人经验的影响因素进行分析。结果表明个人、信息内容、信息源等方面的影响因素均对各渠道的健康信息采纳行为有较好的解释力度。其中，网络健康信息采纳主要受到健康信息形式和信息可执行性的影响，网络健康信息的多媒体形式是其传播健康信息的优势，而信息内容的可执行性方面还需改进。纸质和大众传媒健康信息采纳主要受到信息源权威性、信息形式和信息内容认可度影响，该类渠道代表着权威可信、广受认可的信息源。信息发布者的相似性显著影响采纳人际关系提供的健康信息，患者可通过人际关系获取与自己身份、病症等方面相似的发布者所提供的健康信息。健康素养和感知个体差异显著影响患者采纳个人经验和知识改变其健康行为。 本研究着眼于健康信息对慢性病患者健康行为改变的作用机制，丰富了健康信息行为领域对健康信息采纳、健康信息行为结果等方面的研究，有利于健康信息服务相关机构提升其服务质量，为患者提供可实施、可采纳的健康信息服务。
英文摘要：	Health is of great significance for the development of individuals and the whole society. Chronic disease, owing to its complex pathogenesis, wide range of complications, and long course of disease, has posed a threat to residents’ health status. The number of patients with chronic diseases in China is expanding, and the disease prevention and control work is still facing great challenges. Information is an important factor that affects people’s beliefs, attitudes, and then behavior. Therefore, providing health information services in disease care, treatment, mental health is an important method to improve patients' health behavior and health conditions. Most of the previous studies on health information behavior have focused on patients' health information needs, health information-seeking behavior, influencing factors, and other aspects. Less attention is paid to how patients use health information to change their health behavior after obtaining health information, and what role health information plays in health behavior change. This study uses both qualitative and quantitative research methods to explore the mechanism of health information on health behavior change of patients with chronic diseases. The mechanism model of health information on health behavior change is constructed and tested. First, the investigators used semi-structured in-depth interviews to collect qualitative data, including a sample of 15 diabetes patients. In this study, the open coding method was used to analyze the qualitative data, and to construct a theoretical model of the mechanism of the effect of health information on health behavior change. Based on the Transtheoretical Model of Change, this model reveals the stage of patients’ health behavior change and the information sources, information content, and information role of each stage, and reveals the influencing factors that patients use different sources of health information and actually make health behavior changes. A survey was conducted to collect quantitative data to test the above theoretical model, 219 questionnaires were collected and 205 valid questionnaires remained. Hierarchical regression analysis was used to analyze the influencing factors of information utilization of different sources. The results indicated the factors concerning the aspects of individual characteristics, information content and information sources can explain the health information utilization behavior of all sources well. Among them, the utilization of online health information is mainly affected by the information form and information actionability. The multimedia form of online health information is the advantage of this source, and the actionability of OHI still needs to be improved. The utilization of health information in paper and mass media is mainly affected by the authority of information sources, information form, and recognition of information content. Such sources represent authoritative, credible, and widely recognized health information. The similarity of information authors significantly affects the utilization of interpersonal sources of health information. Patients can obtain the health information provided by people similar to their identity and diseases. Health literacy and perceived individual differences significantly influence patients using personal experience and knowledge to change their health behaviors. This study focuses on the mechanism of health information on health behavior change of patients with chronic diseases, enriching the research of the health information utilization, health information behavior outcome. The results are conducive to improving the quality of health information services and providing patients with useful and actionable health information.
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