Abstract:

Objective To explore the health promotion behaviors among patients with pulmonary tuberculosis （TB），and to analyze its relationship with health locus of control，in order to provide scientific references for improving TB patients’ health-promotion behaviors in clinical nursing care. Methods The interpretive sequence mixed method design was utilized. A convenient sampling was used to enroll 300 TB patients from 2 TB specialized tertiary hospitals in Xi’an as research subjects from January to April 2023. General information questionnaire，Health promoting lifestyle profile-Ⅱ，and Multidimensional health locus of control scale were used to collect data，and single-factor analysis and multiple linear regression analysis were conducted. Purposeful sampling was used to select 11 TB patients for a semi-structured interview，and the Colaizzi 7-step method was used to extract themes. Results In the quantitative study，the total score of health promoting behaviors in 294 TB patients was（110.26±15.74）. Patients’ internal health locus of control，chance health locus of control，and occupational status significantly influenced their health-promotion behaviors（P<0.05）. In the qualitative study，4 themes were extracted，including awakening self-awareness of health，the desire to establish a normal life，the distress of multiple uncertainties，and the immediate effect of authoritative guidance. The qualitative and quantitative studies complemented each other and further verified the relationship between health promotion behaviors and health locus of control of TB patients. Conclusion The level of health-promotion behaviors in TB patients needs to be further improved. Nurses need to take systematic health education as an opportunity by the catalytic effect of individual health awareness，to improve their internal locus of control，reduce their opportunity control tendency due to multiple uncertainties，with the ultimate purpose of helping TB patients form and maintain health promotion behaviors.

Key words: Pulmonary Tuberculosis, Health-Promotion Behaviors, Health Locus of Control, Mix-Method Study, Psychological Nursing

摘要：

目的 调查肺结核患者健康促进行为的现状，并深入剖析其与健康心理控制源的关系，以期为有效提升肺结核患者健康促进行为提供参考。方法 采用混合方法研究中的解释性序列设计。通过方便抽样法，于2023年1月—4月在西安市2所结核病定点医院选取300例肺结核患者作为研究对象，使用一般资料调查表、健康促进生活方式量表-Ⅱ和多维度健康心理控制源量表收集资料，并进行单因素分析、多重线性回归分析。采用目的性抽样法选择11例肺结核患者进行半结构化访谈，采用Colaizzi 7步法提炼主题。结果 量性研究最终纳入294例，肺结核患者健康促进生活方式量表-Ⅱ总分为（110.26±15.74）分；内部控制型健康心理控制源、机遇控制型健康心理控制源和职业状态显著影响其健康行为水平（P<0.05）。质性研究共提炼4个主题，包括自我健康意识的觉醒、建立正常生活秩序的渴望、多重不确定感的困扰及权威性指导的即时效应。质性和量性研究结果互相补充，验证了肺结核患者健康促进行为和健康心理控制源的关系。结论 肺结核患者健康促进行为水平亟需进一步提升。在护理肺结核患者时，需要以健康教育为契机，借助个体健康意识觉醒的催化作用，提升其内部控制型健康心理控制源倾向，降低其因多重不确定感而出现的机遇控制型健康心理控制源倾向，帮助肺结核患者形成并维持持久的健康促进行为。

关键词: 肺结核, 健康促进行为, 健康心理控制源, 混合方法研究, 心理护理学