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Article(id=1324044702089097643, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601473, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1769616000000, receivedDateStr=2026-01-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606456539, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606456539, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606456539, creator=13701087609, updateTime=1793606456539, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1798, endPage=1802, ext={EN=ArticleExt(id=1324044702349144492, articleId=1324044702089097643, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Chain mediating effect of health information acquisition behavior and blood glucose management behavioral decision-making on risk perception and self-management in pregnant women with gestational diabetes mellitus, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the chain mediating role of health information acquisition behavior and blood glucose management behavioral decision-making between risk perception and self-management in pregnant women with gestational diabetes mellitus (GDM).

Methods

Using a convenience sampling method, 353 pregnant women with GDM from four tertiary Grade-A hospitals in Zhengzhou City were selected as participants. They were surveyed using the Risk Perception Scale for Pregnant Women with GDM, the Diabetes Health Information Acquisition Behavior Scale, the Blood Glucose Management Behavioral Decision-Making Scale for Pregnant Women with GDM, and the Self-Management Assessment Scale for GDM. Structural equation modeling and the Bootstrap method were employed to test the mediating effects.

Results

Risk perception was positively associated with self-management in pregnant women with GDM (β=0.676, P<0.001). Health information acquisition behavior was positively associated with self-management (β=0.097, P<0.001), and blood glucose management behavioral decision-making was also positively associated with self-management (β=0.133, P<0.001). The chain mediating effect of both variables was significant (β=0.033, 95%CI: 0.016-0.142, P<0.001), accounting for 4.88% of the total effect. The total mediating effect accounted for 38.91% of the total effect.

Conclusion

Health information acquisition behavior and blood glucose management behavioral decision-making play a chain mediating role between risk perception and self-management in pregnant women with GDM. This suggests that clinical interventions should start with enhancing pregnant women’s risk perception, subsequently promoting their proactive acquisition of health information and optimizing management decisions to ultimately improve self-management behaviors.

, authors=Meng SUN, Hong-ya WANG, Jia LIU, Nan ZHANG, Ying LV, authorsList=Meng SUN, Hong-ya WANG, Jia LIU, Nan ZHANG, Ying LV, authorCompany=null, correspAuthors=Meng SUN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044703095730609, articleId=1324044702089097643, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=妊娠期糖尿病孕妇风险感知对自我管理的影响：健康信息获取与血糖管理决策的链式中介作用, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨健康信息获取行为和血糖管理行为决策在妊娠期糖尿病（Gestational Diabetes Mellitus，GDM）孕妇风险感知与自我管理之间的链式中介作用。

方法

采用便利抽样法，选取郑州市4所三级甲等医院的353名GDM孕妇为研究对象，采用妊娠期糖尿病孕妇风险感知量表、糖尿病健康信息获取行为量表、妊娠期糖尿病孕妇血糖管理行为决策量表及妊娠期糖尿病自我管理评价量表进行调查。采用结构方程模型与Bootstrap法检验中介效应。

结果

风险感知对GDM孕妇自我管理呈显著正向关联（β=0.676，P<0.001）。健康信息获取行为与自我管理间呈正向关联（β=0.097，P<0.001）；血糖管理行为决策与自我管理间呈正向关联（β=0.133，P<0.001），两者的链式中介效应显著（β=0.033，95%CI：0.016~0.142，P<0.001），占总效应的4.88%。总中介效应占总效应的38.91%。

结论

健康信息获取行为和血糖管理行为决策在GDM孕妇风险感知与自我管理之间起链式中介作用。提示临床干预应以提升孕妇风险感知为起点，进而促进其主动获取健康信息并优化管理决策，从而改善自我管理行为。

, authors=孙萌, 王红亚, 刘佳, 章楠, 吕莹, authorsList=孙萌, 王红亚, 刘佳, 章楠, 吕莹, authorCompany=null, correspAuthors=孙萌, authorNote=

孙萌（1988—），女，硕士，主管护师，研究方向：产科护理

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孙萌，E-mail：
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孙萌（1988—），女，硕士，主管护师，研究方向：产科护理

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孙萌（1988—），女，硕士，主管护师，研究方向：产科护理

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(In Chinese), articleTitle=Qualitative study of the health information-seeking behavior of pregnant women with gestational diabetes mellitus, refAbstract=null)], funds=[Fund(id=1324045019337863386, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, awardId=221111310700, language=CN, fundingSource=河南省重点研发计划(221111310700), fundOrder=null, country=null), Fund(id=1324045022882050268, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, awardId=LHGJ20210405, language=CN, fundingSource=河南省医学科技攻关计划项目(LHGJ20210405), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324045014426333356, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, xref=null, ext=[AuthorCompanyExt(id=1324045014434721965, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, companyId=1324045014426333356, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450014, China), AuthorCompanyExt(id=1324045014443110574, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, companyId=1324045014426333356, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=郑州大学第二附属医院，河南 郑州 450014)])], figs=[ArticleFig(id=1324045018687746260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=EN, label=Fig.1, caption=Chain mediation model, figureFileSmall=aynkMaVLqoc75LdM9XGPkg==, figureFileBig=2W88grXipjg64/98ZpHN1g==, tableContent=null), ArticleFig(id=1324045018796798165, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=CN, label=图1, caption=链式中介模型, figureFileSmall=aynkMaVLqoc75LdM9XGPkg==, figureFileBig=2W88grXipjg64/98ZpHN1g==, tableContent=null), ArticleFig(id=1324045018914238678, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=EN, label=Table 1, caption=

Correlation analysis of variables

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项目得分（）风险感知健康信息获取行为血糖管理行为决策自我管理
风险感知103.22±15.361.000
健康信息获取行为163.24±17.650.304a1.000
血糖管理行为决策136.89±19.480.327a0.327a1.000
自我管理129.01±23.090.364a0.424a0.364a1.000
), ArticleFig(id=1324045019010707671, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=CN, label=表1, caption=

各变量相关性分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
项目得分（）风险感知健康信息获取行为血糖管理行为决策自我管理
风险感知103.22±15.361.000
健康信息获取行为163.24±17.650.304a1.000
血糖管理行为决策136.89±19.480.327a0.327a1.000
自我管理129.01±23.090.364a0.424a0.364a1.000
), ArticleFig(id=1324045019107176664, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=EN, label=Table 2, caption=

Test of chain mediation effects

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路径β(95%CI)P值效应占比
（%）
总中介效应0.263(0.156~0.384)<0.00138.91
lnd1：风险感知→健康信息获取行为→自我管理0.097(0.101~0.327)<0.00114.35
lnd2：风险感知→血糖管理行为决策→自我管理0.133(0.132~0.469)<0.00119.68
lnd3：风险感知→健康信息获取行为→血糖管理行为决策→自我管理0.033(0.016~0.142)<0.0014.88
直接效应0.413(0.593~1.213)<0.00161.09
总效应0.676(0.984~1.975)<0.001100.00
对比中介效应：lnd1-lnd2-0.036(-0.215~0.103)0.612
), ArticleFig(id=1324045019195257049, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044702089097643, language=CN, label=表2, caption=

链式中介效应检验

, figureFileSmall=null, figureFileBig=null, tableContent=
路径β(95%CI)P值效应占比
（%）
总中介效应0.263(0.156~0.384)<0.00138.91
lnd1：风险感知→健康信息获取行为→自我管理0.097(0.101~0.327)<0.00114.35
lnd2：风险感知→血糖管理行为决策→自我管理0.133(0.132~0.469)<0.00119.68
lnd3：风险感知→健康信息获取行为→血糖管理行为决策→自我管理0.033(0.016~0.142)<0.0014.88
直接效应0.413(0.593~1.213)<0.00161.09
总效应0.676(0.984~1.975)<0.001100.00
对比中介效应：lnd1-lnd2-0.036(-0.215~0.103)0.612
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妊娠期糖尿病孕妇风险感知对自我管理的影响：健康信息获取与血糖管理决策的链式中介作用
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孙萌 , 王红亚 , 刘佳 , 章楠 , 吕莹
现代预防医学 | 儿少卫生与妇幼保健 2026,53(10): 1798-1802
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (10) : 1798 -1802
妊娠期糖尿病孕妇风险感知对自我管理的影响：健康信息获取与血糖管理决策的链式中介作用
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孙萌 , 王红亚, 刘佳, 章楠, 吕莹
作者信息
  • 郑州大学第二附属医院，河南 郑州 450014
通讯作者:
孙萌，E-mail：
作者简介:

孙萌（1988—），女，硕士，主管护师，研究方向：产科护理

Chain mediating effect of health information acquisition behavior and blood glucose management behavioral decision-making on risk perception and self-management in pregnant women with gestational diabetes mellitus
Meng SUN , Hong-ya WANG, Jia LIU, Nan ZHANG, Ying LV
Affiliations
  • The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450014, China
出版时间: 2026-05-25 doi: 10.20043/j.cnki.MPM.202601473
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摘要
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目的

探讨健康信息获取行为和血糖管理行为决策在妊娠期糖尿病（Gestational Diabetes Mellitus，GDM）孕妇风险感知与自我管理之间的链式中介作用。

方法

采用便利抽样法，选取郑州市4所三级甲等医院的353名GDM孕妇为研究对象，采用妊娠期糖尿病孕妇风险感知量表、糖尿病健康信息获取行为量表、妊娠期糖尿病孕妇血糖管理行为决策量表及妊娠期糖尿病自我管理评价量表进行调查。采用结构方程模型与Bootstrap法检验中介效应。

结果

风险感知对GDM孕妇自我管理呈显著正向关联（β=0.676，P<0.001）。健康信息获取行为与自我管理间呈正向关联（β=0.097，P<0.001）；血糖管理行为决策与自我管理间呈正向关联（β=0.133，P<0.001），两者的链式中介效应显著（β=0.033，95%CI：0.016~0.142，P<0.001），占总效应的4.88%。总中介效应占总效应的38.91%。

结论

健康信息获取行为和血糖管理行为决策在GDM孕妇风险感知与自我管理之间起链式中介作用。提示临床干预应以提升孕妇风险感知为起点，进而促进其主动获取健康信息并优化管理决策，从而改善自我管理行为。

妊娠期糖尿病  /  风险感知  /  健康信息获取行为  /  血糖管理行为决策  /  自我管理  /  链式中介效应
Objective

To explore the chain mediating role of health information acquisition behavior and blood glucose management behavioral decision-making between risk perception and self-management in pregnant women with gestational diabetes mellitus (GDM).

Methods

Using a convenience sampling method, 353 pregnant women with GDM from four tertiary Grade-A hospitals in Zhengzhou City were selected as participants. They were surveyed using the Risk Perception Scale for Pregnant Women with GDM, the Diabetes Health Information Acquisition Behavior Scale, the Blood Glucose Management Behavioral Decision-Making Scale for Pregnant Women with GDM, and the Self-Management Assessment Scale for GDM. Structural equation modeling and the Bootstrap method were employed to test the mediating effects.

Results

Risk perception was positively associated with self-management in pregnant women with GDM (β=0.676, P<0.001). Health information acquisition behavior was positively associated with self-management (β=0.097, P<0.001), and blood glucose management behavioral decision-making was also positively associated with self-management (β=0.133, P<0.001). The chain mediating effect of both variables was significant (β=0.033, 95%CI: 0.016-0.142, P<0.001), accounting for 4.88% of the total effect. The total mediating effect accounted for 38.91% of the total effect.

Conclusion

Health information acquisition behavior and blood glucose management behavioral decision-making play a chain mediating role between risk perception and self-management in pregnant women with GDM. This suggests that clinical interventions should start with enhancing pregnant women’s risk perception, subsequently promoting their proactive acquisition of health information and optimizing management decisions to ultimately improve self-management behaviors.

Gestational diabetes mellitus  /  Risk perception  /  Health information acquisition behavior  /  Blood glucose management behavioral decision-making  /  Self-management  /  Chain mediating effect
孙萌, 王红亚, 刘佳, 章楠, 吕莹. 妊娠期糖尿病孕妇风险感知对自我管理的影响：健康信息获取与血糖管理决策的链式中介作用. 现代预防医学, 2026 , 53 (10) : 1798 -1802 . DOI: 10.20043/j.cnki.MPM.202601473
Meng SUN, Hong-ya WANG, Jia LIU, Nan ZHANG, Ying LV. Chain mediating effect of health information acquisition behavior and blood glucose management behavioral decision-making on risk perception and self-management in pregnant women with gestational diabetes mellitus[J]. Modern Preventive Medicine, 2026 , 53 (10) : 1798 -1802 . DOI: 10.20043/j.cnki.MPM.202601473
正文
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妊娠期糖尿病（Gestational Diabetes Mellitus，GDM）是常见的高危妊娠并发症，可增加孕产妇高血压、早产、感染等风险，并可能对新生儿产生长期影响[1-2]。近年来我国GDM发病率呈逐年上升趋势。妊娠期高血糖诊治指南提到，GDM孕妇做好血糖管理，能够有效稳定血糖水平、改善母婴状况[3]。目前GDM孕妇自我管理水平偏低，尚需进一步提升[4]。健康信念模型（Health Belief Model, HBM）指出个体是否采取健康行为，主要取决于对疾病威胁的感知、对行为益处的判断以及对行为障碍的评估[5]。依据该模型，风险感知作为行为改变的核心动力，可能通过驱动个体采取一系列认知与行为策略，最终影响自我管理。风险感知是指个体对相关健康威胁的严重性和自身易感性的主观评估[6]。健康信息获取行为是指个体在获取、辨别及确认与健康相关知识时表现出的一系列行为[7]。血糖管理行为决策指患者在面对存在不同风险、个人偏好和可能后悔的多种选择时，权衡好坏后做出决定的过程[8]。研究显示提升风险感知可促进GDM孕妇更积极地进行健康信息获取行为，并进行血糖管理行为决策[9]。此外，GDM孕妇的健康信息获取行为能够提高认知水平，促进血糖管理行为决策，从而增强自我管理信心[10]。因此，本研究基于HBM，构建以风险感知为自变量，健康信息获取行为和血糖管理行为决策为中介变量，自我管理为因变量的链式中介模型，以期为GDM孕妇自我管理干预方案提供依据。
1　对象与方法
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1.1　调查对象
采用便利抽样法，于2024年12月至2025年2月，选取在郑州市4所三级甲等医院住院的GDM孕妇。纳入标准：①年龄20周岁及以上；②单胎妊娠；③经75 g口服葡萄糖耐量试验确诊为GDM。排除标准：①合并其他妊娠并发症者；②伴有认知功能障碍或精神疾病无法完成问卷调查者。参照量性研究样本量计算方法[11]：样本量为变量总个数的10～15倍，本研究共30个变量，考虑10%的样本流失率，计算出样本量为333~500例。最终纳入353名GDM孕妇。本研究已通过郑州大学第二附属医院伦理委员会审批（KY2025077）。
1.2　调查工具
1.2.1　一般资料调查表
由研究者自行设计，包括：①一般人口学资料：年龄、家庭人均月收入、学历等；②疾病相关资料：孕周、孕次、产次、流产史等。
1.2.2　妊娠期糖尿病孕妇风险感知量表
由陈钰妹等[12]编制，共包含4个维度，29个条目。采用Likert 5级评分法，从“非常不重要”到“非常重要”分别计为1~5分，其中严重性感知和易感性感知维度采取正向计分，其余维度采取反向计分。总分范围为29～145分。得分越高表明孕妇的风险感知水平越高。本研究中该量表的Cronbach α系数为0.945，表明其可靠性良好。
1.2.3　糖尿病健康信息获取行为量表
由Kalantzi等[13]编制，王美凤等[14]等汉化修订，共包含8个维度，38个条目。采用Likert 5级评分法，从“从不~总是”分别计为1~5分。总分为38~190分，得分越高表明孕妇的健康信息获取行为越显著。本研究中该量表的Cronbach α系数为0.947。表明其可靠性良好。
1.2.4　妊娠期糖尿病孕妇血糖管理行为决策量表
由彭玉美等[15]编制，共包括4个维度，34个条目。采用Likert 5级评分法，从“完全不同意~完全同意”分别计为1~5分，总分为34～170分，得分越高表明孕妇的血糖管理行为决策水平越好。本研究中该量表的Cronbach α系数为0.949。表明其可靠性良好。
1.2.5　妊娠期糖尿病自我管理评价量表
由张霞等[16]编制，包括4个维度，32个条目。采用Likert 5级评分法。从“从不~总是”分别计为1~5分，总分为32～160分。得分越高表明孕妇的自我管理水平越高。本研究中该量表的Cronbach α系数为0.974。表明其可靠性良好。
1.3　资料收集
本研究在收集数据前，向符合纳入标准的GDM孕妇详细说明研究目的及填写要求，承诺问卷匿名填写并严格保密。在获得知情同意后，采用统一指导语进行调查，问卷当场发放并当场收回。共发放问卷360份，回收有效问卷353份，有效回收率为98.05%。
1.4　统计学方法
使用SPSS 27.0统计软件进行数据分析。计量资料正态性检验符合正态分布以均数±标准差描述；计数资料采用频数、百分比描述。采用Harman单因子检验法对所有测量条目进行共同方法偏差检验。采用Pearson相关分析检验GDM孕妇风险感知、血糖管理行为决策、健康信息获取行为和自我管理之间的相关性。采用Amos 26.0软件构建链式中介的结构方程模型，模型的拟合指标包括：卡方自由度比（χ2/df）、拟合优度指数（GFI）、比较拟合指数（CFI）、递增拟合指数（IFI）、Tucker-Lewis指数（TLI）、近似误差均方根（RMSEA）。采用偏差校正Bootstrap法（重复抽样5 000次）进行中介效应检验，计算95%置信区间。双侧检验水准设定为α=0.05。
2　结果
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2.1　GDM孕妇一般资料
本研究共纳入353名GDM孕妇，年龄20~46（31.22±3.13）岁，其中26~30岁118人（33.43%），31~35岁223人（63.17%），≥36岁12人（3.40%）；孕次：1次142人（40.23%），2次129人（36.54%），≥3次82人（23.23%）；产次：0次231人（65.44%），1次102人（28.90%），≥2次20人（5.66%）；接受过辅助生殖技术者166人（47.03%）；学历：高中/中专45人（12.75%），大专73人（20.68%），本科185人（52.41%），研究生及以上50人（14.16%）；计划妊娠218人（61.76%），非计划妊娠135人（38.24%）；婚姻状况：已婚330人（93.48%），未婚/再婚/离异23人（6.52%）；有宗教信仰22人（6.23%），无宗教信仰331人（93.77%）；家庭人均月收入：≤3 000元81人（22.95%），3 001~5 000元175人（49.58%），>5 000元97人（27.47%）。
2.2　共同方法偏差检验结果
结果显示，特征根大于1的公因子共提取5个（分别为31.275、11.387、9.829、8.144、5.863），其中首个公因子的方差解释率为23.52%，低于40%的临界值标准[22]，表明本研究不存在严重的共同方法偏差。
2.3　变量描述性统计及相关性分析
Pearson相关分析结果显示，GDM孕妇风险感知、健康信息获取行为、血糖管理行为决策、自我管理两两之间均呈正相关（P<0.05）。具体见表1。
2.4　链式中介模型分析
以风险感知为自变量，健康信息获取行为与血糖管理行为决策为中介变量，自我管理为因变量，构建结构方程模型，结果见图1。模型拟合指数显示：χ2/df值为2.121（<3），GFI、IFI、TLI、CFI值均大于0.90，RMSEA值为0.054（<0.08），表明模型拟合良好。采用Bootstrap法进行中介效应检验，结果显示各间接效应的95%置信区间均不包含0，表明中介效应显著。链式中介效应为0.033，占总效应的4.88%。总中介效应值为0.263，占总效应的38.91%，直接效应值为0.413，占总效应的61.09%。各路径的具体效应值、置信区间及效应占比详见表2。
3　讨论
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3.1　风险感知对GDM孕妇自我管理的直接影响
本研究结果显示，风险感知能直接正向影响GDM孕妇的自我管理水平（直接效应值0.413，占总效应的61.09%），与既往研究结果一致[17]。根据健康信念模型，风险感知是个体采取健康行为的核心动力[5]。当GDM孕妇对疾病可能引发的母婴并发症（如巨大儿、早产、远期代谢风险等）形成清晰、准确的认知时，其对疾病威胁的评估更为深刻，从而更倾向于采取积极的管理行为以降低风险[18]。因此，临床健康教育应将风险沟通作为首要环节，帮助孕妇建立科学、适度的风险认知。
3.2　健康信息获取行为、血糖管理行为决策对GDM孕妇自我管理的间接影响
本研究结果显示风险感知影响自我管理的两条关键中介路径。首先，健康信息获取行为在风险感知与自我管理之间发挥中介作用（Ind1效应值0.097，占14.35%），与Anataca等[10]研究结果一致。根据健康信念模型，当孕妇对GDM形成较高水平的风险感知后，会产生强烈的心理不适与不确定感，进而激发其主动寻求专业、可靠健康信息的动机，以降低不确定性并寻找应对策略。通过系统获取和理解疾病管理知识，孕妇不仅增强了自我效能感，也为其后续采取具体管理行为提供了清晰的知识框架与操作指引，从而直接促进自我管理水平的提升。这提示，在临床健康教育中，强化风险感知教育是启动孕妇信息寻求行为的重要切入点。其次，血糖管理行为决策在风险感知与自我管理之间同样发挥中介作用（Ind2效应值0.133，占19.68%）。当孕妇深刻认识到血糖控制不佳的严重后果时，会在面对日常选择（如饮食种类、运动安排）时更倾向于做出以健康优先为导向的决策。这种决策倾向为其自我管理行为提供了明确的价值排序与行动导向。周英凤等[9]的研究也表明，风险感知能够直接影响GDM孕妇的血糖管理决策行为。因此，干预中不仅需关注信息供给，也应重视帮助孕妇在认知层面建立清晰的风险与行为联结，使其在决策时能自发地将健康后果纳入权衡。
3.3　健康信息获取行为与血糖管理行为决策的链式中介作用
本研究在GDM孕妇群体中验证了“风险感知→健康信息获取行为→血糖管理行为决策→自我管理”的链式中介路径（Ind3效应值0.033，占4.88%），揭示了风险感知通过驱动信息获取、进而优化决策、最终提升自我管理的路径。基于健康信念模型，个体从风险感知到行为改变需经历完整的认知加工过程，风险感知首先激发认知准备行为，即主动寻求健康信息以降低不确定性[5]；只有在充分掌握相关信息的基础上，个体才能对不同行为选项进行理性权衡，从而形成科学的管理决策[19]。换言之，信息获取是决策形成的认知基础，决策则是信息加工的行为输出，二者存在明确的时序先后关系。这一链式路径揭示了GDM孕妇自我管理能力提升的完整链条。单纯提升风险感知而缺乏信息支持，孕妇可能陷入焦虑而无从下手；仅提供信息而未协助其转化为决策，知识则难以落地为行动。因此，临床干预应从“点状干预”转向“链式干预”，以风险感知为起点，以信息获取为桥梁，以决策优化为关键节点，最终促成自我管理行为的形成与维持。这一发现为构建全病程、参与式的GDM管理模式提供了实践方向。
本研究仍存在一定局限性：第一，横断面设计无法完全推断因果时序，虽基于理论构建了当前路径，但仍不能完全排除反向路径存在的可能性；第二，未探讨信息获取行为与管理决策之间的交互作用。未来可采用纵向设计进一步验证变量间的动态因果关系。基于上述发现，建议临床干预应将风险感知评估纳入GDM孕妇常规产检流程，采用可视化工具帮助孕妇建立科学的风险认知；同时构建系统化的信息支持体系，依托远程医疗平台提供分阶段健康信息推送；并在信息支持基础上推广共享决策模式，协助孕妇形成个性化管理方案，从而最大化促进自我管理行为的形成与维持。
基金
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  • 河南省重点研发计划(221111310700)
  • 河南省医学科技攻关计划项目(LHGJ20210405)
文献
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2026年第53卷第10期
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doi: 10.20043/j.cnki.MPM.202601473
  • 接收时间：2026-01-29
  • 首发时间：2026-11-02
  • 出版时间：2026-05-25
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  • 收稿日期：2026-01-29
基金
河南省重点研发计划(221111310700)
河南省医学科技攻关计划项目(LHGJ20210405)
作者信息
    郑州大学第二附属医院，河南 郑州 450014

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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