Self-Care Behavior and Associated Factors of Nursing Students with Dysmenorrhea: A Structural Equation Model

Abstract

Objective: To assess the factors influencing the self-care behavior among nursing students with dysmenorrhea.

Background: The practice of self-care behavior for dysmenorrhea has gradually attracted immense attention from society; however, thus far, only a few studies have been conducted to predict this behavior and analyze the associated factors by creating a structural equation model.

Methods: A cross-sectional multistage cluster sampling study was conducted among nursing students within six universities in Shaanxi province, China. A model was constructed, and structured questionnaires were adopted to measure model variables, including e-health literacy, negative emotion, self-efficacy, self-care agency, degree of dysmenorrhea, and self-care behavior for dysmenorrhea. Descriptive data analysis was performed using SPSS 23.0 software, and AMOS 23.0 was used to verify and analyze the structural model.

Results: In total, 1851 valid questionnaires were collected; the effective recovery rate was 93.15%, and the prevalence of dysmenorrhea was 64.51%. e-Health literacy (B = 0.171, P < 0.001), self-efficacy (B = 0.416, P < 0.001), self-care agency (B = 1.177, P < 0.001), and degree of dysmenorrhea (B = 0.310, P < 0.001) significantly influenced self-care behavior for dysmenorrhea. The total, direct, and indirect effects of e-health literacy and self-efficacy on self-care behavior for dysmenorrhea were 0.158 and 0.492, 0.128 and 0.248, and 0.030 and 0.244, respectively.

Conclusion: The self-care behavior for dysmenorrhea is affected by several factors and self-efficacy has the greatest effect on it. To promote girls to actively implement self-care behavior for dysmenorrhea, educators should strengthen the training of self-efficacy and self-care agency of the nursing students to alleviate the uncomfortable experience brought by dysmenorrhea and decrease the harm of dysmenorrhea. Implications for Nursing Management. Nursing managers should work with constant efforts to explore and optimize the management model for dysmenorrhea, encouraging young women to actively engage in self-care behavior for dysmenorrhea, to alleviate the discomfort experienced by individuals and improve women's overall health.

Figure 1

Theoretical framework.

Figure 2

Structural equation model of self-care behavior of medical students with dysmenorrhea. X11: test the application capability of network health information and service; X12: judging ability; X13: decision-making ability; X21: depressed; X22: anxiety; X23: stress; X31: nourishment; X32: movement; X33: psychological comfort; X34: health responsibility; Y11: health knowledge level; Y12: self-concept; Y13: self-care responsibility; Y14: self-care skills; Y21: pain-related symptom; Y22: autonomic nervous disorder; Y23: water and sodium retention; Y31: acquired knowledge; Y32: emotional expression; Y33: ask for help; Y34: control external factors; Y35: resource utilization. ^∗P < 0.05, ^∗∗P < 0.01.