{
  "abstract": "Background: Self-management behavior is closely linked to clinical outcomes and quality of life in hemodialysis patients, but evidence from high-resource East Asian regions, where behavioral execution remains paradoxically difficult, is limited.\n\nObjective: To identify factors associated with self-management behavior and examine dimensional interactions based on the COM-B model among hemodialysis patients in Eastern China.\n\nMethods: This cross-sectional study enrolled 345 hemodialysis patients from two tertiary hospitals in Hangzhou (September 2023 – September 2024). Data were collected using electronic questionnaires, including a general information form and the Chinese Hemodialysis Self-Management Behavior Scale. Descriptive statistics, univariate analysis, and forced-entry multiple linear regression were performed.\n\nResults: Mean self-management score was 2.88±0.60 (moderate; range 1–4). Dimension scores: partnership (3.24±0.65), emotional management (3.09±0.70), problem-solving (2.86±0.68), and self-care behavior (2.57±0.68). Independent factors identified by multiple regression were education (β=0.230), marital status (β=0.213), income (β=0.206), dialysis vintage (β=0.203), and complications (β=−0.202), all P<0.05. Hierarchical regression showed no significant interactions among COM-B dimensions (ΔR2=0.000–0.004, all P>0.05), suggesting additive rather than multiplicative effects – a pattern not previously reported. The model explained 32.0% of the variance (adjusted R2=0.289). Education and dialysis vintage reflect capability; marital status and income reflect opportunity; complications affect both capability and motivation.\n\nConclusion: Self-management behavior was moderate, with self-care being the weakest domain. Education (capability) was the strongest positive factor, while complications (capability/motivation depletion) showed the most prominent negative effect. Causal inferences are precluded by the cross-sectional design. In similar eastern urban settings, low education, low income, divorce/widowhood, and heavy comorbidity burden represent potential intervention targets. Future research should design and validate stratified interventions across COM-B dimensions.",
  "abstract_shown": true,
  "affiliations": [
    "Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, 310015, People’s Republic of China",
    "The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China",
    "The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310000, People’s Republic of China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ling Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Chenxin Yu"
    },
    {
      "affs": [
        0
      ],
      "name": "Qin Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanping Niu"
    },
    {
      "affs": [
        0
      ],
      "name": "Pei Chen"
    },
    {
      "affs": [
        2
      ],
      "name": "Anling Yao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a9knabgcw8qvd.bib",
  "cited_by": 0,
  "doi": "10.2147/ppa.s608526",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738246/",
  "id": "a9knabgcw8qvd",
  "issns": [
    "1177-889X"
  ],
  "landing_url": "https://doi.org/10.2147/ppa.s608526",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2727|Dialysis and Renal Disease Management"
    ]
  ],
  "openalex": "W7225007810",
  "pdf_url": "https://www.dovepress.com/article/download/121714",
  "pmcid": "PMC13738246",
  "pmid": "42992193",
  "published": "2026-11-01",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/a9knabgcw8qvd.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:16Z",
      "native_id": "PMC13738246",
      "source": "pmc",
      "url": "https://doi.org/10.2147/ppa.s608526"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Dialysis and Renal Disease Management",
      "subfield": "general"
    }
  ],
  "title": "Factors Associated with Self-Management Behavior in Hemodialysis Patients in Eastern China: A COM-B Model-Based Cross-Sectional Study",
  "title_text": "Factors Associated with Self-Management Behavior in Hemodialysis Patients in Eastern China: A COM-B Model-Based Cross-Sectional Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:16Z",
  "url": "https://research.draconitic.com/paper/a9knabgcw8qvd",
  "venue": "Patient preference and adherence",
  "versions": []
}