Predicting dietary management intention of patients with chronic kidney disease using protection motivation theory

Li, Huijie; Deng, Yueyi; Huang, Yitong; Blake, Holly

Abstract

Background
Psychological determinants underlying the dietary management intention (DMI) of Chinese patients with chronic kidney disease (CKD) are not well understood. This hinders the development of theory-informed dietary interventions targeting this population. The aim of this study was to identify factors influencing DMI of Chinese patients with CKD through the lens of Protection Motivation Theory (PMT).

Methods
500 patients with CKD from a nephrology ward of a large teaching hospital in China completed a survey including measures of PMT constructs (i.e., perceived vulnerability, perceived severity, intrinsic and extrinsic rewards, self-efficacy, response efficacy, and response cost) using validated scales adapted from previous studies. Data were analyzed using confirmatory factor analysis and multiple linear regression.

Results
Three PMT constructs, namely perceived severity [B = 0.198, P < 0.001], response efficacy [B = 0.331, P  < 0.001], and self-efficacy [B = 0.325, P  < 0.001], two demographic variables, namely single status [B = -0.180, P = 0.028] and education level [B = 0.080, P = 0.007], and a disease-related variable, namely CKD stage [B = .056, P = 0.001], predicted 39.3% of the variance of the CKD DMI. No significant effect on CKD DMI was observed for other predictor variables (P > 0.05).

Conclusions
Applying the PMT, significant predictors of DMI in Chinese patients with CKD were identified, which should be targeted in behavior change initiatives aimed at promoting dietary management.

Citation

Li, H., Deng, Y., Huang, Y., & Blake, H. (2025). Predicting dietary management intention of patients with chronic kidney disease using protection motivation theory. PLoS ONE, 20(3), Article e0320340. https://doi.org/10.1371/journal.pone.0320340

• Journal Article Type: Article
• Acceptance Date: Feb 18, 2025
• Online Publication Date: Mar 18, 2025
• Publication Date: Mar 18, 2025
• Deposit Date: Mar 5, 2025
• Publicly Available Date: Mar 5, 2025
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 3
• Article Number: e0320340
• DOI: https://doi.org/10.1371/journal.pone.0320340
• Keywords: Protection Motivation Theory, diet, behavior change, chronic kidney disease, chronic renal insufficiency
• Public URL: https://nottingham-repository.worktribe.com/output/46189486
• Publisher URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0320340