Behavioral Pathways Associated with Nutritional Self-Management Among Patients Undergoing Maintenance Hemodialysis: A Cross-Sectional IMB Model-Guided Path Analysis.

Authors

Ting Wu, Liping Wang, Hui Si, Weiwei Zhang, Weixiang Luo, Jiaxiu Deng

Published in

Patient preference and adherence. Volume 20. Pages 647632. Epub Oct 02, 2026.

Abstract

To examine factors associated with nutritional self-management behavior and their hypothesized relationships within the Information-Motivation-Behavioral Skills (IMB) framework among patients undergoing maintenance hemodialysis (MHD).
This single-center cross-sectional study included a convenience sample of 215 patients undergoing MHD at a tertiary hospital in Shenzhen, China, between January and May 2026. Questionnaires assessed hemodialysis knowledge, health beliefs, social support, self-management, and nutritional self-management behavior. Pearson correlations and multiple linear regression were analyzed. Because the initially planned latent-variable structural equation model showed inadequate measurement-model fit, an observed-variable path analysis using composite scores was conducted. Indirect associations were estimated using 5000 bias-corrected bootstrap resamples.
The mean nutritional self-management behavior score was 86.47 ± 9.86 (scoring rate, 72.06%). In the regression model, health beliefs (β = 0.190, P = 0.003) and self-management (β = 0.365, P < 0.001) were positively associated with nutritional self-management behavior. In the path model, health beliefs had the largest coefficient for self-management (β = 0.437, P = 0.001), and self-management had the largest coefficient for nutritional self-management behavior (β = 0.380, P < 0.001). Hemodialysis knowledge, health beliefs, and social support showed significant indirect associations through self-management; the largest was for health beliefs (β = 0.166). Explained variance was 25.7% for self-management and 33.2% for nutritional self-management behavior.
These cross-sectional associations provide preliminary evidence consistent with the hypothesized IMB framework. Longitudinal and intervention studies are needed to establish temporal relationships and evaluate potential intervention strategies.

PMID:
42840786
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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