Applying the theory of planned behavior to investigate type 2 diabetes patients' intention to receive injection therapy

Exploring the Willingness of Young and Middle-Aged CHD Patients to Participate in Home-Based Cardiac Rehabilitation: A Qualitative Study

Purpose

With the rapid development of medical science and technology and the increasing trend of coronary heart disease (CHD) rejuvenation, home-based cardiac rehabilitation (HBCR), with its unique advantages, shows great potential for application in the field of prevention and treatment of CHD. In-depth understanding of the subjective perception and willingness to participate in HBCR of patients with CHD is crucial to the precise formulation of rehabilitation programs and the promotion of the clinical application of HBCR. The aim of this study was to explore the factors influencing young and middle-aged CHD patients' willingness to participate in HBCR.

Patients and Methods

This study used the qualitative descriptive approach. Using purposive sampling, a total of 20 young and middle-aged patients with CHD who were admitted to a tertiary hospital in Taiyuan from June to August 2024 were selected to participate in this study. This study used the theory of planned behavior (TPB) as the theoretical framework to carry out data collection and analysis. Face-to-face, semi-structured interviews were used to collect the data. Data were analyzed using content analysis. Two researchers independently read, coded, categorized, and refined themes.

Results

Based on the framework of the TPB, four themes emerged from the analysis: (1) attitude; (2) subjective norm; (3) perceived behavioral control; and (4) Knowledge mastery level. Of the 20 participants in this study, 15 participants had positive attitudes toward HBCR, but their willingness to participate was still influenced by multiple factors. Economic conditions are the fundamental factor influencing patients' willingness to participate in HBCR. Social support, self-efficacy, emotional state, and knowledge mastery level are also crucial. The lack of face-to-face professional guidance and the HBCR risks perceived by patients impede their participation. Moreover, the social roles of young and middle-aged CHD patients are a unique factor influencing their willingness to participate.

Conclusion

Under the guidance of TPB, this study deeply explored the factors influencing young and middle-aged CHD patients' willingness to participate in HBCR. Based on these factors, it is necessary to make precise interventions in the future at the government level, among healthcare professionals, and within social support systems. By identifying these factors, we can not only improve patients' willingness to rehabilitate and the rehabilitation effect, help them return to society, and reduce social pressure, but also promote the clinical application of HBCR and optimize the CR grading system.

Predictors of shared decision-making in patients with recurrent and metastatic nasopharyngeal carcinoma: An observational structural equation modeling approach

PURPOSE

This investigation examines the interrelationships between SDM and key behavioral factors-decision-making attitude, self-efficacy, nurse-patient trust, and intention-among Chinese r/m NPC patients through structural equation modeling, guided by the Theory of Planned Behavior.

METHODS

A cross-sectional investigation following STROBE guidelines. Through convenience sampling, 301 r/m NPC patients were enrolled from a Southern Chinese tertiary cancer center between November 2023 and June 2024. Participants completed comprehensive assessments including demographic data, the Decision Self-Efficacy Scale, Cancer Patients' Decision-Making Regarding Treatment Scale, Nurse-Patient Trust Scale, and Expectation of Involvement in Medical Decision-Making Scale.

RESULTS

The mean score of SDM among patients with r/m NPC was 18.25 ± 6.29, indicating a low-middle level of SDM. Older age (β = 3.179) contributed to the low SDM level. The results of the structural equation model show that decision-making attitude (β = 0.254) and decision-making intention (β = -0.740) have direct effects on SDM. Furthermore, decision-making attitude (β = -0.453) and decision-making self-efficacy (β = 0.430) can indirectly influence SDM through the decision-making intention.

CONCLUSION

Healthcare professionals could utilize these pathway-specific findings to enhance shared decision-making implementation. Given the low-middle participation level, especially among elderly patients, healthcare providers should prioritize strategies that strengthen decision-making intention and foster positive participation attitudes. Future interventions should be tailored based on these identified pathways to effectively promote shared decision-making in clinical practice.

Applying behavioral change theories to optimize pulmonary rehabilitation in COPD patients: A review

This review meticulously evaluates the integration of behavioral change theories into pulmonary rehabilitation programs for chronic obstructive pulmonary disease (COPD) management, addressing the critical need for enhanced patient compliance and improved therapeutic outcomes. With COPD posing significant global health challenges, characterized by high morbidity and mortality rates, the manuscript underscores the potential of Self-Determination Theory, Social Cognitive Theory, the Transtheoretical Model, the Health Belief Model, and the Theory of Planned Behavior to foster meaningful health behavior changes among patients. Through a comprehensive literature analysis, it reveals how each model contributes to understanding patient behaviors in pulmonary rehabilitation contexts, advocating for their systematic application to craft more effective, patient-centered interventions. Despite the proven efficacy of these theories in various health domains, their current underutilization in pulmonary rehabilitation underscores a gap between theoretical knowledge and clinical practice. The review calls for an interdisciplinary approach that bridges this gap, highlighting the urgency of developing actionable, theory-based behavioral intervention plans. By doing so, it aims to advance COPD management strategies, ultimately improving the quality of life for individuals living with this debilitating disease.

Influencing factors of health screening among retirees: an extended TPB approach

Background

Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE).

Methods

This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE.

Results

A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively.

Conclusion

This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.