Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 49 min ago
Peer-reviewedCC BY-NC 4.0Patient preference and adherence

Factors Associated with Self-Management Behavior in Hemodialysis Patients in Eastern China: A COM-B Model-Based Cross-Sectional Study

  • Ling Li1
  • Chenxin Yu2
  • Qin Lin1
  • Yanping Niu1
  • Pei Chen1
  • Anling Yao3
  1. 1Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, 310015, People’s Republic of China
  2. 2The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China
  3. 3The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310000, People’s Republic of China
Read full textPDFDOICite

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.

Objective: To identify factors associated with self-management behavior and examine dimensional interactions based on the COM-B model among hemodialysis patients in Eastern China.

Methods: 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.

Results: 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.

Conclusion: 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.

Related

  1. Serum Myonectin Levels Are Positively Associated With Physical Function and Lower Frailty‐Related Limitation in Maintenance Hemodialysis Patients: A Cross‐Sectional Study
    Kenichi Kono, Yoshifumi Moriyama, Koji Ohashi +5
    Therapeutic Apheresis and DialysisPeer-reviewedCC BY-NC 4.0Full textGeneral medicinePMC
  2. Prevalence and factors associated with physical function among patients undergoing maintenance hemodialysis in Buraydah, Saudi Arabia: a cross-sectional study.
    Shereen Ahmed A Qalawa, Wafaa Abdullah AlQassem, Kholoud Metab Alomeri +4
    Frontiers in nephrologyPeer-reviewedCC BYFull textGeneral medicineEurope PMCPMC
  3. Factors associated with self-management behavior among pregnant women with diet-controlled gestational diabetes mellitus in China: A cross-sectional study.
    Jiali Xu, Tatirat Tachasuksri, Punyarat Lapvongwatana
    Belitung nursing journalPeer-reviewedCC BY-NCFull textObstetrics, gynaecology & paediatricsEurope PMC
  4. Development of a nomogram for identifying prevalent medication discrepancy in maintenance hemodialysis patients: a multicenter cross-sectional study
    Xiaodan Lin, Mianzhou Liu, Zhaochuan Li +7
    Frontiers in medicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  5. Construction and validation of an identification model for frailty in maintenance hemodialysis patients using multiple machine learning algorithms: a cross-sectional study of retrospectively collected data
    Jiao Wang, Ping Yu, Wenjuan Sun +7
    Annals of medicinePeer-reviewedCC BY-NCFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{li2026factors,
  title = {{Factors Associated with Self-Management Behavior in Hemodialysis Patients in Eastern China: A COM-B Model-Based Cross-Sectional Study}},
  author = {Ling Li and Chenxin Yu and Qin Lin and Yanping Niu and Pei Chen and Anling Yao},
  journal = {Patient preference and adherence},
  year = {2026},
  month = nov,
  doi = {10.2147/ppa.s608526},
  url = {https://doi.org/10.2147/ppa.s608526},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Factors Associated with Self-Management Behavior in Hemodialysis Patients in Eastern China: A COM-B Model-Based Cross-Sectional Study
AU  - Ling Li
AU  - Chenxin Yu
AU  - Qin Lin
AU  - Yanping Niu
AU  - Pei Chen
AU  - Anling Yao
PY  - 2026
DA  - 2026/11/01
JO  - Patient preference and adherence
DO  - 10.2147/ppa.s608526
UR  - https://doi.org/10.2147/ppa.s608526
AB  - 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.  Objective: To identify factors associated with self-management behavior and examine dimensional interactions based on the COM-B model among hemodialysis patients in Eastern China.  Methods: 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.  Results: 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.  Conclusion: 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.
SN  - 1177-889X
ER  -