A study on the information-motivation-behavioural skills model among Chinese adults with peritoneal dialysis.

AIM AND OBJECTIVE: To examine whether the information-motivation-behavioural skills model could predict self-care behaviour among Chinese peritoneal dialysis patients. BACKGROUND: Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The information-motivation-behavioural model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation and evaluation of self-care programmes. DESIGN: A cross-sectional, observational study. METHODS: A total of 201 adults with peritoneal dialysis were recruited at a 3A grade hospital in China. Participant data were collected on demographics, self-care information (knowledge), social support (social motivation), self-care attitude (personal motivation), self-efficacy (behaviour skills) and self-care behaviour. We also collected data on whether the recruited patients had peritoneal dialysis-associated peritonitis from electronic medical records. Measured variable path analysis was performed using mplus 7.4 to identify the information-motivation-behavioural model. RESULTS: Self-efficacy, information and social motivation predict peritoneal dialysis self-care behaviour directly. Information and personal support affect self-care behaviour through self-efficacy, whereas peritoneal dialysis self-care behaviour has a direct effect on the prevention of peritoneal dialysis-associated peritonitis. CONCLUSIONS: The information-motivation-behavioural model is an appropriate and applicable model to explain and predict the self-care behaviour of Chinese peritoneal dialysis patients. Poor self-care behaviour among peritoneal dialysis patients results in peritoneal dialysis-associated peritonitis. RELEVANCE TO CLINICAL PRACTICE: The findings suggest that self-care education programmes for peritoneal dialysis patients should include strategies based on the information-motivation-behavioural model to enhance knowledge, motivation and behaviour skills to change or maintain self-care behaviour.

Flexural Strengthening of Large-Scale RC Beams with Nonprestressed and Prestressed CFRP Using Different Anchorages.

Externally bonded carbon-fiber-reinforced polymer (CFRP) technology can be used by different methods based on the anchorage device, CFRP type, and prestressing/nonprestressing. However, a direct comparison between the strengthening efficacies of different methods is still lacking. Seven large-scale RC beams were tested in this study to investigate the influences of the anchorage method, CFRP type, prestress, and prestressing system on the flexural strengthening efficacy of RC beams. The test results showed that the ultimate load increased by 38.3%, whereas the cracking and yielding loads were slightly affected when the anchorage method was enhanced from CFRP U-wraps to wedge-clamp anchors. The CFRP plate and CFRP sheet could provide a rather close flexural strengthening efficacy under the same CFRP strengthening amount. Compared to the nonprestressed CFRP plate, the prestressed CFRP plate was highly superior in improving the flexural behavior of RC beams. The cracking, yielding, and ultimate loads of the prestressed CFRP-strengthened specimens were 57.1%, 22.9%, and 5.9%, respectively, higher than those of the nonprestressed CFRP-strengthened specimen with an effective anchorage. The two types of prestressing systems based on the adhesive-friction anchor and wedge-clamp anchor were proven to be effective for flexural strengthening of RC beams with prestressed CFRP plates, and they could provide almost the same strengthening effect.