CAJ | 학술논문

目的健康信念模式和理性/计划行为理论是健康行为学领域应用较为广泛的两大理论,多项解释和预测健康行为的研究将两种理论综合运用,以提高解释程度.本文通过系统文献回顾,分析这两种理论综合应用的方式,探索不同健康行为的共性影响因素,为健康促进和健康教育干预策略的选择提供参考.方法按照预定检索策略在9个中英文数据库中共检索到322篇文献索引,按照研究设计的主要音部分提取关键信息并根据Strobe Checklist和Cochrane Handbook for Systematic Reviews of Interventions评价质量.结果最终纳入40篇文献,共计37项研究,6项研究为高质量,其余均为中等质量.纳入研究多为为横断面调查,对理论的应用形式主要为开发研究工具.部分研究选取行为意向代替实际行为作为结局变量,行为意向的主要影响因素是主观规范、感知易患性和知觉行为控制;行为的主要影响因素是感知障碍、行为意向和知觉行为控制.结论综合应用两种理论的细节上需加强规范性.通过健康教育提高个体的感知疾病易患性,通过扩展目标人群提高个体的主观规范,可成为健康行为的共同干预途径,提高干预效果;建议今后相关研究应确定个体对于特定行为的感知障碍和控制信念,制定相应干预措施.
목적 건강신념모식화이성/계화행위이론시건강행위학영역응용교위엄범적량대이론,다항해석화예측건강행위적연구장량충이론종합운용,이제고해석정도.본문통과계통문헌회고,분석저량충이론종합응용적방식,탐색불동건강행위적공성영향인소,위건강촉진화건강교육간예책략적선택제공삼고.방법 안조예정검색책략재9개중영문수거고중공검색도322편문헌색인,안조연구설계적주요음부분제취관건신식병근거Strobe Checklist화Cochrane Handbook for Systematic Reviews of Interventions평개질량.결과 최종납입40편문헌,공계37항연구,6항연구위고질량,기여균위중등질량.납입연구다위위횡단면조사,대이론적응용형식주요위개발연구공구.부분연구선취행위의향대체실제행위작위결국변량,행위의향적주요영향인소시주관규범、감지역환성화지각행위공제;행위적주요영향인소시감지장애、행위의향화지각행위공제.결론 종합응용량충이론적세절상수가강규범성.통과건강교육제고개체적감지질병역환성,통과확전목표인군제고개체적주관규범,가성위건강행위적공동간예도경,제고간예효과;건의금후상관연구응학정개체대우특정행위적감지장애화공제신념,제정상응간예조시.
Objective Health belief model and theory of reasoned action or theory of planned behavior have been used widely in studies of health behavior and combined to use in many studies to explain and predict definite health behaviors.A systematic review was conducted to analyze how two theories combined in the studies related to health behaviors,to explore general factors influencing different health behaviors,and so that to provide evidence for future health promotion and health education strategies.Methods Nine databases were searched using predetermined search strategies and 322 indexes were identified.Key information of included studies was extracted and the quality of each one was assessed according to Strobe Checklist and Cochrane Handbook for Systematic Reviews of Interventions.Results 40 papers including 37 studies were finally included in this review.6 studies were of high quality,while others were of medium quality.Most studies were cross-sectional survey.Two theories were usually as the framework basis and used to develop research instruments in the included studies.Some researchers used behavioral intention as an outcome variable instead of actual behavior.Subjective norms,perceived susceptibility,and perceived behavior control were the most influencing factors for behavioral intention;perceived barriers,behavioral intention,and perceived behavior control were the most influencing factors for behavior.Conclusions There are some limitations need to avoid in the future studies synthetically using HBM and TRA/TPB.Improving individuals' perceived susceptibility and subjective norms by extending the target population can serve as the common intervention to change health behaviors;further studies should identify individuals' perceived barriers and control beliefs of specific behaviors,and make responding interventions.