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已发表论文
农村心房颤动患者依从Atrial Fibrillation Better Care（ABC）路径的相关因素：基于健康行为改变整合理论的路径分析
Authors Huang J , Chen J , Ye Q, Cai X, Feng Y, Lai X, Diao X, Dai Q, Zhang X, Li K
Received 15 August 2025
Accepted for publication 30 December 2025
Published 20 January 2026 Volume 2026:20 556835
DOI https://doi.org/10.2147/PPA.S556835
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Jun Huang,1,* Jing Chen,2,* Qirao Ye,3 Xiaomei Cai,4 Yuanchun Feng,4 Xinwei Lai,3 Xiulin Diao,3 Qingxiang Dai,5 Xiaomin Zhang,2,6 Kun Li2
1Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China; 2School of Nursing, Sun Yat-sen University, Guangzhou, People’s Republic of China; 3Department of Cardiology, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 4Chronic Disease Management Center, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 5Electrocardiogram Room, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 6Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaomin Zhang, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China, Tel +86 18811332158, Email zhangxiaom@sysucc.org.cn Kun Li, School of Nursing, Sun Yat-sen University, No. 74 Zhong Shan second Road, Guangzhou, 510080, People’s Republic of China, Tel +86 13822206519, Email likun22@mail.sysu.edu.cn
Background: 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.
Aim: 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.
Methods: 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.
Results: Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability (β = 0.449; P< 0.001) and social support (β = 0.429; P< 0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge (β = 0.211; P< 0.001), AF health beliefs (β = 0.350; P< 0.001) and social support (β = 0.085; P< 0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge (β = 0.121; P< 0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability.
Conclusion: AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.
Keywords: atrial fibrillation, guideline adherence, rural population, knowledge, health belief, self-management, social support
1Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China; 2School of Nursing, Sun Yat-sen University, Guangzhou, People’s Republic of China; 3Department of Cardiology, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 4Chronic Disease Management Center, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 5Electrocardiogram Room, People’s Hospital of Shangyou County, Ganzhou, People’s Republic of China; 6Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaomin Zhang, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China, Tel +86 18811332158, Email zhangxiaom@sysucc.org.cn Kun Li, School of Nursing, Sun Yat-sen University, No. 74 Zhong Shan second Road, Guangzhou, 510080, People’s Republic of China, Tel +86 13822206519, Email likun22@mail.sysu.edu.cn
Background: 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.
Aim: 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.
Methods: 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.
Results: Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability (β = 0.449; P< 0.001) and social support (β = 0.429; P< 0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge (β = 0.211; P< 0.001), AF health beliefs (β = 0.350; P< 0.001) and social support (β = 0.085; P< 0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge (β = 0.121; P< 0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability.
Conclusion: AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.
Keywords: atrial fibrillation, guideline adherence, rural population, knowledge, health belief, self-management, social support