脑卒中患者健康行为结构方程模型构建研究

目的 构建脑卒中患者健康行为结构方程模型,定量分析模型中影响因素对健康行为作用路径及强度。方法 以知信行模式为框架,构建健康行为结构方程模型,采用最大似然法对初始模型进行拟合,拟合度采用RMSEA、GFI、AGFI、IFI、TLI、CFI进行检验;采取路径系数分析健康知识、信念及行为之间作用路径。结果 整体适配度CMIN/DF<3,GFI、IFI、TLI、CFI均>0.90,AGFI>0.80,RMSEA<0.08;健康知识、信念、行为三个潜变量组合信度均>0.80,聚敛效度均>0.50;健康知识对健康信念直接效应0.45,健康信念对健康行为直接效应0.49,健康知识对健康行为直接效应0.31,健康知识对健康行为间接效应0.22,健康知识对健康行为总效应0.53。结论 模型具有较好整体适配度及内在结构适配度;健康知识及信念对健康行为有直接影响,健康知识对健康行为除直接作用外,还通过健康信念中介作用间接影响健康行为。

Construction of structural equation modeling for health behavior of stroke

Objective To construct the structural equation modeling for health behavior of stroke patients,and to quantitatively analyze the action path and strength of various factors on health behavior in the model.Methods The structural equation modeling for health behavior was constructed based on knowledge-attitude-belief-practice (KABP) model.The maximum likelihood method was conducted to fit the initial model,and the fitting index was tested by RMSEA,GFI,AGFI,IFI,TLI and CFI.Path coefficient was used to analyze the path between health knowledge,beliefs and behavior.Results The overall fitness of the model:CMIN/DF<3,GFI,IFI,TLI,CFI>0.90,AGFI>0.80,RMSEA<0.08.The combination reliability of the three latent variables,including health knowledge,belief and behavior,was above 0.80,and the convergent validity were all above 0.50.Health knowledge had direct effects on health beliefs and health behaviors with impact coefficients of 0.45 and 0.31,respectively.Health beliefs had a direct effect on health behaviors with an impact coefficient of 0.49.The impact coefficients of indirect effect and total effect health knowledge put on health behaviors were 0.22 and 0.53,respectively.Conclusion The good overall fitness and internal structure adaptation have been showed in structural equation model.Health knowledge and beliefs have a direct impact on health behavior,and the former also have an indirect effect on health behavior through the mediating effect of health belief.