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Objective To explore the potential impact pathways of self-management behavior based on COM-B model, in maintenance hemodialysis (MHD) patients, and provide reference for the intervention of self-management behavior. Methods Judgment sampling was used to select 350 MHD patients undergoing dialysis at the hospital in a certain district of Guangzhou, and a questionnaire survey was conducted among them. Smart PLS software was used to construct a partial least squares structural equation model and perform path analysis. Results Self-management behavior score of MHD patients was (57.06 ± 13.28). Univariate analysis showed that age, education background, employment status, occupational classification, per capita monthly income of families, and the number of comorbidities could directly affect self-management behavior of MHD patients (P < 0.05). PLS-SEM model showed that self-efficacy (β = 0.246), family care level (β = 0.124) and social support (β = 0.140) positively impacted patients' self-management behavior, while disease perception negatively affected self-management behavior(β = -0.097). Self-efficacy can mediate the impact of disease perception and social support on self-management behavior of MHD patients (P < 0.05). Conclusions Self-management behavior of MHD patients is currently at a low level. Therefore, when devising intervention plans for these patients, it is crucial to consider the combined effects of disease knowledge education, disease perception reconstruction, opportunity provision, and motivation. The primary focus should be on enhancing patients' self-efficacy, which will ultimately elevate their overall level of self-management. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between socioeconomic status (SES), illness perception, social functioning, and health-related quality of life (HRQoL) of young and middle-aged maintenance hemodialysis (MHD) patients and the internal mechanism of action. Design: A multicenter cross-sectional study. Methods: An aggregate of 332 young and middle-aged MHD patients were enrolled from hemodialysis centers in four general hospitals in Guangzhou, Guangdong, China, from June to December 2022. The questionnaires used included one for general demographic data, the Brief Illness Perception Questionnaire (BIPQ), Social Dysfunction Screening Scale (SDSS), and the 12-item Short Form Health Survey (SF-12). Results: Both SES and HRQoL were negatively correlated with illness perception and social functioning, respectively. SES was positively correlated with HRQoL. Illness perception was positively correlated with social functioning. The indirect effects of illness perception and social functioning on the relationship between SES and HRQoL were 0.33 and 0.31, making up 41.06% and 38.91% of the sum. The chain indirect effect of illness perception and social functioning was 0.10, making up 12.59% of the total effect, while gender did not play a moderating role. Conclusion: Illness perception and social functioning may independently and accumulatively mediate the association between SES and HRQoL. Nurses should consider developing individual intervention program for young and middleaged MHD patients with low SES, focusing on establishing targeted counseling and health education strategies corresponding to illness perception and social functioning to help patients improve their HRQoL. [ABSTRACT FROM AUTHOR]