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      Patient Preference and Adherence (submit here)

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      Effect of a Health Belief Model-based education program on patients’ belief, physical activity, and serum uric acid: a randomized controlled trial

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          Abstract

          Objective

          We aimed to investigate the effect of a Health Belief Model (HBM)-based education program on the perception scores of 5 HBM domains, physical activity, and serum uric acid (SUA) among asymptomatic hyperuricemia (AHU) patients in a randomized controlled trial.

          Methods

          One hundred and ninety-three AHU patients were involved in this prospective experimental interventional study in Shanghai, China. Subjects were randomly divided into interventional or control group. The educational program was designed based on HBM component for the improvement of knowledge and promotion of lifestyle adherence in terms of low-purine diet and physical activity among AHU patients. This program included educational booklets and educational classes. Data were collected from interventional and control group members both before and after the intervention, using a questionnaire covering sociodemographic characteristics, HBM variables, physical activity from the Health-Promoting Lifestyle Profile II, and a check list for recording the subject’s SUA values, as well as the body mass index, waist–hip ratio, systolic blood pressure, and diastolic blood pressure.

          Results

          In the interventional group, the mean scores of the HBM variables (perceived susceptibility, perceived severity, perceived benefit, perceived barriers, and self-efficacy), SUA values, physical activity, body mass index, and waist–hip ratio were improved significantly after the intervention ( p<0.05), whereas no significant differences were detected in the control group between baseline and follow-up measures.

          Conclusion

          This study showed the importance of the educational program based on the HBM in improving the model constructs and physical activity, as well as in decreasing the SUA values in AHU patients.

          Most cited references23

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          Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal?

          Elevated serum uric acid concentration is a common laboratory finding in subjects with metabolic syndrome/obesity, hypertension, kidney disease and cardiovascular events. Hyperuricemia has been attributed to hyperinsulinemia in metabolic syndrome and to decreased uric acid excretion in kidney dysfunction, and is not acknowledged as a main mediator of metabolic syndrome, renal disease, and cardiovascular disorder development. However, more recent investigations have altered this traditional view and shown, by providing compelling evidence, to support an independent link between hyperuricemia and increased risk of metabolic syndrome, diabetes, hypertension, kidney disease and cardiovascular disorders. However, despite these new findings, controversy regarding the exact role of uric acid in inducing these diseases remains to be unfolded. Furthermore, recent data suggest that the high-fructose diet in the United State, as a major cause of hyperuricemia, may be contributing to the metabolic syndrome/obesity epidemic, diabetes, hypertension, kidney disease and cardiovascular disorder. Our focus in this review is to discuss the available evidence supporting a role for uric acid in the development of metabolic syndrome, hypertension, renal disease, and cardiovascular disorder; and the potential pathophysiology mechanisms involved.
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            The health belief model and personal health behavior

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              The importance of health belief models in determining self-care behaviour in diabetes.

              Patients' self-care behaviours have a major role in diabetes management. Diabetes education provides the required knowledge, but despite this, self-care is often suboptimal. The degree to which patients follow advice as regards the various self-care behaviours is determined by their health beliefs (Illness Representations or Personal Models) of diabetes. Psychometric studies have tried to categorize and measure the beliefs about illness that influence patients to adhere to treatment recommendations in diabetes. Various models have been proposed to explain the relationship between beliefs and behaviour. Leventhal's Self-Regulatory Model, which takes account of the emotional as well as the objective rational response to illness, currently seems to offer the best system for identifying the determinants of patient self-care behaviour. A review of interventions indicates those based on psychological theory offer professionals the best chance of maximizing their patients' contribution to diabetes self-management and achieving improved outcomes, both glycaemic and psychosocial. Studies designed specifically to modify illness representations are now being undertaken. This brief review aims to summarize developments in this area of psychological theory over the last 20 years and the implications for promoting better self-care behaviour in diabetes.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2018
                17 July 2018
                : 12
                : 1239-1245
                Affiliations
                [1 ]Department of Nutrition, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China, third_CNLP@ 123456163.com
                [2 ]Key Laboratory of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, People’s Republic of China
                [3 ]Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, li.hua3@ 123456zs-hospital.sh.cn
                Author notes
                Correspondence: Jingfang Liu, Department of Nutrition, Huashan Hospital, Fudan University, 12 Wu-Lu-Mu-Qi-Zhong Road, Shanghai 200040, People’s Republic of China, Tel +86 21 5288 9999, Email third_CNLP@ 123456163.com
                Hua Li, Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, 180 Feng-Lin Road, Shanghai 200032, People’s Republic of China, Tel +86 21 6404 1990, Email li.hua3@ 123456zs-hospital.sh.cn
                [*]

                These authors contributed equally to this work

                Article
                ppa-12-1239
                10.2147/PPA.S166523
                6054292
                30046238
                45b2380a-f670-443e-92bd-ce36249fca64
                © 2018 Shao et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Medicine
                health belief model,asymptomatic hyperuricemia,education,adherence
                Medicine
                health belief model, asymptomatic hyperuricemia, education, adherence

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