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Tang S, Li X, Wang M, Sha L. Nutrition literacy mediates the relationship between self-efficacy and eating behavior in young tuberculosis patients: A cross-sectional study. Prev Med Rep 2023; 33:102187. [PMID: 37223557 PMCID: PMC10201870 DOI: 10.1016/j.pmedr.2023.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 05/25/2023] Open
Abstract
Objective To assess the associations between self-efficacy, nutrition literacy and eating behavior, and to examine if nutrition literacy mediates the relationship between self-efficacy and eating behavior in young tuberculosis patients. Methods This cross-sectional study used a convenience sampling strategy to select 230 young tuberculosis patients at the Second Hospital of Nanjing (Public Health Medical Center of Nanjing), China, from June 2022 to August 2022. The data were collected using a demographic data form, the Eating Behavior Scale, the Food and Nutrition Literacy Questionnaire and the Tuberculosis Self-Efficacy Scale. Descriptive statistics, Pearson bivariate correlation analysis, Pearson partial correlation analysis, hierarchical multiple regression, and mediation analysis were conducted in the study. Results The mean self-efficacy score for young tuberculosis patients was 92.56 (SD = 9.89, range = 21 ∼ 105). The average nutrition literacy score for young tuberculosis patients was 68.24(SD = 6.75, range = 0 ∼ 100). The bivariate correlation analysis and partial correlation analysis found that self-efficacy was positively correlated with nutrition literacy (P < 0.01). The regression analysis showed that self-efficacy (F = 5.186, β = 0.233, P < 0.001)and nutrition literacy (F = 7.749, β = 0.545, P < 0.001) significantly predicted eating behavior. The three dimensions of nutrition literacy including nutritional knowledge (mediation effect ratio = 13.1%, 95% CI = - 0.089; -0.005), preparing food (mediation effect ratio = 17.4%, 95 %CI = 0.011; 0.077) and eating (mediation effect ratio = 54.7%, 95 %CI = 0.070; 0.192) mediated the relationship between self-efficacy and eating behavior in young tuberculosis patients. Conclusion Nutrition literacy mediated the relationship between self-efficacy and eating behavior. To promote healthy eating behavior among young tuberculosis patients, interventions aimed at improving self-efficacy and nutrition literacy should be conducted.
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Affiliation(s)
- Suyao Tang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing 210023, China
| | - Xinyue Li
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing 210023, China
| | - Mengmeng Wang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing 210023, China
| | - Li Sha
- Medical Examination Centre, Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine (The Second Hospital of Nanjing), 1-1 Zhongfu Road, Nanjing 210023, China
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Wu J, Shen J, Tao Z, Song Z, Chen ZL. Self-Efficacy as Moderator and Mediator Between Medication Beliefs and Adherence in Elderly Patients with Type 2 Diabetes. Patient Prefer Adherence 2023; 17:217-226. [PMID: 36713972 PMCID: PMC9875572 DOI: 10.2147/ppa.s382362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Poor antidiabetic medication adherence remains a great barrier to effective diabetes self-management among aging adults. This study investigates the mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence in elderly patients with type 2 diabetes. METHODS This cross-sectional study evaluated a sample of 309 hospitalized elderly patients who completed the assessment of medication beliefs, self-efficacy for medication uses and medication adherence in a tertiary hospital in Shanghai, China. A bootstrapping sampling method and hierarchical moderator regression analysis were used to verify the hypothesis of mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence. RESULTS Self-efficacy for medication use acted as a moderator (B=-0.063, t=-2.215, p=0.028) and partial mediator (CItotal effect=4.5-16.63, p=0.001; CIindirect=1.524-5.323, p=0.014; CIdirect=2.151-11.817, p=0.001) on the relationship between general harm medication beliefs and medication adherence. Participants with lower general harm medication beliefs may develop higher self-efficacy, which, in turn, results in a higher level of medication adherence, and higher self-efficacy may attenuate the negative effect of high general harm medication beliefs on medication adherence. CONCLUSION Self-efficacy for medication use not only mediated the relationship between general harm beliefs about medication and medication adherence, but moderated it negatively. The findings of this study indicate an opportunity to improve the prognosis of elderly Chinese patients with type 2 diabetes through improved medication adherence by strengthening factors such as self-efficacy for appropriate medication use and general harm beliefs about medication.
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Affiliation(s)
- Jianbo Wu
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jie Shen
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Jie Shen; Zhi-Long Chen, Email ;
| | - Zhujun Tao
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhongjuan Song
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhi-Long Chen
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
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Wang L, Liang C, Yu H, Zhang H, Yan X. Reliability and validity evaluation of the appropriate antibiotic use self-efficacy scale for Chinese adults. BMC Public Health 2022; 22:1344. [PMID: 35836244 PMCID: PMC9284704 DOI: 10.1186/s12889-022-13729-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Antibiotic resistance is one of the greatest threats to global public health. Inappropriate use of antibiotics can lead to an increase in antibiotic resistance. Individual self-efficacy in the appropriate use of antibiotics plays a key role, especially in China where the population has easy access to antibiotics. However, there are no tools available to assess the self-efficacy of appropriate antibiotic use for Chinese adults. We aimed to translate and develop a Chinese version of the Appropriate Antibiotic Use Self-Efficacy Scale (AAUSES), and validate its reliability and validity. Methods A total of 659 adults were recruited to participate in the questionnaire. The original version scale was first translated into Chinese using the backward and forward translation procedures. The internal consistency reliability of the scale was measured by the Cronbach alpha coefficient, the test-retest reliability, and the corrected item-total correlation. The validity of the scale was assessed by the content validity index, exploratory factor analysis, and confirmatory factor analysis. Results The content validity index of the scale was 0.96. Exploratory factor analysis (EFA) supported a 4-factor structure of the translated questionnaire, and the discriminant validity of the scale was good. Confirmatory factor analysis (CFA) showed in the model fitness index, the chi-square degree of freedom was 2.940, the goodness-of-fit index(GFI) was 0.929, the incremental fit index (IFI) was 0.908, the comparative fit index(CFI) was 0.906, root mean square error of approximation(RMSEA) was 0.077, and standardized root mean residual (SRMR) was 0.0689, and the model fitting indexes were all in the acceptable range. Cronbach alpha coefficient for the scale was 0.910. The test-retest reliability was 0.947, and the corrected item-total correlations for the items ranged from 0.488 to 0.736. Self-efficacy for appropriate antibiotic use in adults varied by education, occupation, income, place of residence, and whether or not they had heard of antibiotic resistance. Conclusions The results indicated that the Chinese version of the AAUSES had good reliability and validity. Therefore, it can be considered a tool to evaluate the appropriate antibiotic use self-efficacy of adults in China.
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Affiliation(s)
- Liying Wang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Chunguang Liang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China.
| | - Haitao Yu
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Hui Zhang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Xiangru Yan
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
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Ren J, Han D, Zhang J, Wang Y, Huang Q, Tian T, Li X. Development and Psychometric Testing of the Supportive Care Needs Scale for Patients with Tuberculosis (SCN-TB). Patient Prefer Adherence 2021; 15:2267-2278. [PMID: 34675491 PMCID: PMC8502070 DOI: 10.2147/ppa.s330225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Patients affected by tuberculosis have diverse unmet supportive care needs (SCN) that may seriously affect their treatment adherence. Accurately assessing patients' SCN is important for providing efficient patient-centred care, but few instruments are suitable for use in clinical practice. Therefore, the purpose of this study was to develop an SCN scale for patients with tuberculosis (SCN-TB) and to evaluate its psychometrical properties. PATIENTS AND METHODS Based on the SCN framework, the SCN-TB was designed via a literature review, Delphi consultation and pilot study. Then, 550 patients from four tuberculosis specialist hospitals in Shaanxi Province were enrolled by convenience sampling to further test the validity and reliability of the SCN-TB. RESULTS A total of 518 patients completed the survey. The final scale encompasses 25 items in five domains: physical, practical, psycho-emotional, social, and informational. The content validity for the scale was 0.93, with that for each item ranging from 0.80 to 1.00. Five factors that explained 80.38% of the variance were identified in exploratory factor analysis. A five-factor model was then confirmed with confirmatory factor analysis using maximum likelihood estimation with bootstrapping. The model fit indices were χ 2/df=1.062 (Bollen-Stine χ 2=281.382, df=265, p<0.001), CFI=0.997, RMSEA=0.016, SRMR=0.053, NFI=0.951, and GFI=0.929. All factors had acceptable convergent and discriminant validity. The Cronbach's α, split-half, and test-retest reliability coefficients of the scale were 0.884, 0.883, and 0.854, respectively. CONCLUSION The SCN-TB is a valid and reliable theory based tool for assessing the needs of patients with tuberculosis and can be applied in both clinical practice and research.
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Affiliation(s)
- Jing Ren
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an City, People’s Republic of China
| | - Dongfang Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an City, People’s Republic of China
| | - Jingjun Zhang
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an City, People’s Republic of China
| | - Yingli Wang
- Department of Internal Medicine of Tuberculosis, Fourth Hospital of Inner Mongolia Autonomous Region, Hohhot City, People’s Republic of China
| | - Qiaoqiao Huang
- Department of Nursing, Fourth Hospital of Inner Mongolia Autonomous Region, Huhhot City, People’s Republic of China
| | - Tian Tian
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an City, People’s Republic of China
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an City, People’s Republic of China
- Correspondence: Xiaomei Li School of Nursing, Health Science Center, Xi’an Jiaotong University, No. 76 Yanta West Road, Yanta District, Xi’an City, Shanxi, 710061, People’s Republic of ChinaTel/Fax +86 29 82657017 Email
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Wu J, Tao Z, Song Z, Zhang Y, Sun H, Wang J, Shen J. Validation and psychometric properties of the self-efficacy for Appropriate Medication Use Scale in elderly Chinese patients. Int J Clin Pharm 2020; 43:586-594. [PMID: 33044679 DOI: 10.1007/s11096-020-01167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Abstract
Background Self-efficacy for appropriate medication use is an important construct when evaluating the optimal use of medications. However, no instrument that assesses this construct in elderly Chinese patients has been shown to have valid psychometric properties. Objective To investigate the psychometric properties of the Chinese version of the self-efficacy for Appropriate Medication Use Scale in elderly patients with type 2 diabetes. Setting Geriatric patients were recruited from the endocrinology department of a tertiary hospital in Shanghai, China. Method Self-efficacy was assessed by the Chinese version of the Self-Efficacy for Appropriate Medication Use Scale in subjects who were at least 65 years old. Exploratory and confirmatory factor analyses were used to develop a psychometrically sound model of the scale. Main outcome measures Internal and test-retest reliability; convergent and discriminant validity of the scale; model fit indices of the factor model. Results The two-factor model of the self-efficacy for Appropriate Medication Use Scale was not suitable for elderly patients with respect to both item factor loadings and model fit indices. Conceptually overlapping scale items emerged when the scale was used in these patients. The final model developed appeared to achieve an ideal model fit and presented acceptable convergent and discriminant validity. Conclusions This study presented a Chinese version of the self-efficacy for Appropriate Medication Use Scale with psychometrically sound properties that will enable pharmacists, nurses and physicians to prospectively evaluate the impact of medication self-efficacy on a variety of health outcomes in elderly patients with type 2 diabetes.
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Affiliation(s)
- Jianbo Wu
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Zhujun Tao
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Zhongjuan Song
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Yunxuan Zhang
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Hua Sun
- Department of Endocrinology, Huadong Hospital, Fudan University, Shanghai, China
| | - Jiaofeng Wang
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Jie Shen
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China.
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