Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with Atrial Fibrillation: A Path Analysis Based on the Integrated Theory of Health Behavior Change (ITHBC).
心房颤动更好的照护（ABC）路径是心房颤动（AF）综合管理的有效策略。然而，中国农村AF患者对ABC路径的依从率极低。基于健康行为改变整合理论（ITHBC）探讨农村AF患者ABC路径依从性的影响因素及机制。在这项横断面研究中，我们于2022年7月至2023年9月从中国农村地区招募了940例AF患者。患者完成了一份问卷，涵盖AF相关的人口学和临床特征、AF知识、AF健康信念、AF自我管理能力和社会支持。ABC路径依从性根据AF人口学和临床特征进行评估。采用路径分析探讨变量之间的关系。农村AF患者对ABC路径的依从性极低（5.7%）。AF自我管理能力（=0.449；<0.001）和社会支持（=0.429；<0.001）直接且正向影响ABC路径依从性。此外，AF知识（=0.211；<0.001）、AF健康信念（=0.350；<0.001）和社会支持（=0.085；<0.001）也可通过AF自我管理能力间接且正向影响ABC路径依从性。AF知识（=0.121；<0.001）可通过AF健康信念和AF自我管理能力的一系列中介间接影响ABC路径依从性。AF知识、AF健康信念和社会支持是重要的干预组成部分，应紧密结合AF自我管理能力。
The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with AF is extremely low. To explore the factors and mechanisms of adherence to the ABC pathway based on the integrated theory of health behavior change (ITHBC) among rural patients with AF. In this cross-sectional study, we recruited 940 patients with AF from rural areas in China from July 2022 to September 2023. Patients completed a questionnaire covering AF-related demographic and clinical characteristics, AF knowledge, AF health beliefs, AF self-management ability, and social support. Adherence to ABC pathway was assessed based on AF-demographic and clinical characteristics. Path analysis was used to explore the relationship between variables. Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability ( = 0.449; <0.001) and social support ( = 0.429; <0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge ( = 0.211; <0.001), AF health beliefs ( = 0.350; <0.001) and social support ( = 0.085; <0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge ( = 0.121; <0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability. AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.
Jun Huang, Jing Chen, Qirao Ye, Xiaomei Cai, Yuanchun Feng, Xinwei Lai, et al. Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with Atrial Fibrillation: A Path Analysis Based on the Integrated Theory of Health Behavior Change (ITHBC).. Patient preference and adherence. 2026; doi:10.2147/PPA.S556835.
Jun Huang, Jing Chen, Qirao Ye, Xiaomei Cai, Yuanchun Feng, Xinwei Lai, et al (2026). Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with Atrial Fibrillation: A Path Analysis Based on the Integrated Theory of Health Behavior Change (ITHBC).. Patient preference and adherence. https://doi.org/10.2147/PPA.S556835
Jun Huang, Jing Chen, Qirao Ye, Xiaomei Cai, Yuanchun Feng, Xinwei Lai, et al. Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with Atrial Fibrillation: A Path Analysis Based on the Integrated Theory of Health Behavior Change (ITHBC).[J]. Patient preference and adherence, 2026 doi:10.2147/PPA.S556835.
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