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| Title: | 健康信念模式中自覺罹患性與自我管理之後設分析：以糖尿病為例
Meta-Analysis of Perceived Diabetes Susceptibility of Health Belief Model and Self-Management |
| Authors: | 鄭筱彤
Tong, Teh Xiao |
| Contributors: | 韓義興
Han, Yi-Hsing
鄭筱彤
Teh Xiao Tong |
| Keywords: | 健康傳播
健康信念模式
自覺罹患性
糖尿病
自我管理
Health communication
Health Belief Model
Perceived susceptibility
Diabetes
Self-management |
| Date: | 2024 |
| Issue Date: | 2024-09-04 15:06:16 (UTC+8) |
| Abstract: | 健康信念模式（Health Belief Model）被廣泛應用於各種疾病和不同文化情境下的公共衛生及防治宣導研究，用以解釋和預測公眾信念與健康行為之間的相關性，在探討採行糖尿病自我管理的相關研究中亦不乏其例（Hochbaum et al.,1952; Rosenstock, 1974; Khosravizadeh et al., 2021; Karl et al., 2022）。然而，從過往關於健康信念模式的後設分析研究亦可見，模式中的重要要素與健康行為間並不必然具有相關性，尤其是「自覺罹患性」（perceived susceptibility）在最近期的後設分析結果中被認為跟健康行為近乎無關（Carpenter, 2010）。在糖尿病自我管理的文獻中，自覺罹患性與自我管理間相關與否，多有歧異。
為進一步探究前揭問題，本研究以後設分析方法，依系統性的納入及排除條件篩選出18篇研究（33組效果量），探討健康信念模式中自覺罹患性與糖尿病自我管理的關係，同時檢視教育水準和研究參與者的所在地區是否會影響兩者間的相關性。本研究發現：首先，整體而言，糖尿病患者自覺罹患併發症的信念與整體的自我管理呈正相關，尤其是服藥和血糖監測兩種自我管理行為。儘管這一發現與健康信念模式的預測相一致，但本研究結果顯示該相關性較弱。其次，教育程度和所在地區均會影響糖尿病患者的自覺罹患性與自我管理之間的相關性。對於教育程度低於中學學歷的糖尿病患者而言，增強其自覺罹患併發症的信念更有助於促進其採取及遵循自我管理。儘管美洲、東地中海和東南亞的糖尿病患者之自覺罹患性與自我管理間存在正相關，但各區域患者之間的相關性強度存在差異，伊朗和沙地阿拉伯等東地中海地區的相關性最強。
本研究建議，未來在健康傳播與防治策略可著重於強化糖尿病患者對罹患併發症的信念，從而促進其採取並遵循自我管理行為，特別是針對教育程度較低或居住於美洲、東地中海及東南亞地區的患者。然而，應注意的是，單憑強化自覺罹患性這一構念，對於全面促進糖尿病患者採取和遵循自我管理行為的效果有限，需結合其他健康信念模式的構念進行健康傳播和教育干預，以更好地促使患者實現健康行為的改變。
The Health Belief Model (HBM) has been widely utilized in public health research and intervention studies to explain and predict the relationship between beliefs and health behaviours across various diseases and cultural settings (Hochbaum et al., 1952; Rosenstock, 1974; Karl et al., 2022). This model has also been applied in studies on diabetes self-management (Khosravizadeh et al., 2021). Despite its broad application, past meta-analyses of the HBM have revealed inconsistencies in the relationships between its key constructs and health behaviours. For instance, recent analysis has shown that perceived susceptibility is almost unrelated to health behaviour (Carpenter, 2010). The relationship between perceived susceptibility and diabetes self-management remains unclear, with findings varying across studies.
To further address the aforementioned issues, a meta-analysis of 18 studies (33 effect sizes) was conducted to examine the relationship between perceived susceptibility, as conceptualized by the HBM, and diabetes self-management. Additionally, this study explored the possibility of education level and geographic location influencing this relationship. The findings indicate that, overall, perceived susceptibility to diabetes complications was positively correlated with self-management among diabetic patients, especially patients with medication adherence and blood glucose monitoring. While these findings align with the HBM’s predictions, the observed correlation was relatively weak. Furthermore, both education level and geographic location significantly influenced the relationship between perceived susceptibility and diabetes self-management. For diabetic patients with lower educational attainment (below secondary school), an enhanced perception of susceptibility to complications is more likely to facilitate adherence to self-management compare to patients with higher educational attainment. Although there was a positive correlation between perceived susceptibility and self-management among diabetic patients in the Americas, Eastern Mediterranean, and Southeast Asia, the strength of this relationship varied across regions, with the strongest correlations observed in the Eastern Mediterranean, particularly in countries like Iran and Saudi Arabia.
Based on these findings, this study suggests that future health communication and intervention strategies should focus on enhancing diabetic patient’s beliefs regarding the risk of developing complications, thereby encouraging the adoption and adherence to self-management behaviour. This is particularly pertinent for patients with lower educational attainment and those residing in the Americas, the Eastern Mediterranean, and Southeast Asia. However, it is crucial to note that solely emphasizing perceived susceptibility may have limited effectiveness in comprehensively promoting self-management behaviours. A more comprehensive approach that integrates additional constructs of the HBM is necessary to achieve more substantial health behaviour changes. |
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| Description: | 碩士
國立政治大學
傳播學院傳播碩士學位學程
111464055 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0111464055 |
| Data Type: | thesis |
| Appears in Collections: | [傳播學院傳播碩士學位學程] 學位論文
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