{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:50Z","timestamp":1792787270658,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Fifth Batch of Hospital Key Discipline Construction Projects-Clinical Nursing","award":["2022YYZDXK01"],"award-info":[{"award-number":["2022YYZDXK01"]}]},{"name":"Toint Funds of Science and Technology of Fujian Province","award":["2021Y0023"],"award-info":[{"award-number":["2021Y0023"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,3]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to understand influencing factors of health promotion behaviour in patients with aortic dissection (AD) using the capability, opportunity, motivation, behaviour (COM-B) model of behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive qualitative design was adopted. Data were collected using face-to-face semi-structured interviews and analysed using directed content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Fujian Medical University Union Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A purposive sample of 16 patients with AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The following themes and subthemes were identified. Psychological capability: (1) lack of disease knowledge; physical capability: (1) physical function limitation; (2) fatigue; physical opportunity: (1) limited access to disease knowledge; (2) communication between providers and patients; (3) objective condition restriction; social opportunity: (1) stigma; (2) social support; reflective motivation: (1) self-efficacy; (2) perceived benefits; (3) personal and family responsibilities; automatic motivation: (1) post-traumatic growth; (2) fear of disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study adopted a novel approach to understanding factors affecting health promotion behaviour among patients with AD. Interventions can be implemented using the Behaviour Change Wheel framework and study findings to improve health promotion behaviour in this patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076181","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:25:19Z","timestamp":1741199119000},"page":"e076181","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Influencing factors of health promotion behaviour in patients with aortic dissection: a qualitative study using the COM-B model"],"prefix":"10.1136","volume":"15","author":[{"given":"Jia","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Lan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaolin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7486-6278","authenticated-orcid":false,"given":"Baolin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-4754","authenticated-orcid":false,"given":"Liangwan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6890-7552","authenticated-orcid":false,"given":"Yanjuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China"},{"name":"Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"2025121408105335000_15.3.e076181.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.04.023"},{"key":"2025121408105335000_15.3.e076181.2","article-title":"Incidence and Survival of Aortic Dissection in Urban China: Results from the National Insurance Claims for Epidemiological Research (NICER) Study","volume":"17","author":"Tang","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"key":"2025121408105335000_15.3.e076181.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.029"},{"key":"2025121408105335000_15.3.e076181.4","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1093\/ejcts\/ezaa197","article-title":"Stroke in acute type A aortic dissection: the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD)","volume":"58","author":"Chemtob","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025121408105335000_15.3.e076181.5","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/clc.22418","article-title":"Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function","volume":"38","author":"Chaddha","year":"2015","journal-title":"Clin Cardiol"},{"key":"2025121408105335000_15.3.e076181.6","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1053\/j.semtcvs.2021.03.040","article-title":"Quality of Life Worsens After Surgical Repair of Acute Type A Aortic Dissection","volume":"34","author":"St. Pierre","year":"2022","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2025121408105335000_15.3.e076181.7","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.015060","article-title":"From Tear to Fear: Posttraumatic Stress Disorder in Patients With Acute Type A Aortic Dissection","volume":"9","author":"Pasadyn","year":"2020","journal-title":"JAHA"},{"key":"2025121408105335000_15.3.e076181.8","first-page":"258","article-title":"Effectiveness of mobile health applications on clinical outcomes and health behaviors in patients with coronary heart disease: A systematic review and meta-analysis","volume":"11","author":"Zhu","year":"2024","journal-title":"Int J Nurs Sci"},{"key":"2025121408105335000_15.3.e076181.9","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.5982","article-title":"Effectiveness and Cost-effectiveness of an Empowerment-Based Self-care Education Program on Health Outcomes Among Patients With Heart Failure: A Randomized Clinical Trial","volume":"5","author":"Yu","year":"2022","journal-title":"JAMA Network Open"},{"key":"2025121408105335000_15.3.e076181.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"2025121408105335000_15.3.e076181.11","doi-asserted-by":"crossref","DOI":"10.1186\/s13019-023-02124-5","article-title":"The relationship between quality of life and health promotion behavior in patients with type B aortic dissection: a cross-sectional study","volume":"18","author":"Tu","year":"2023","journal-title":"J Cardiothorac Surg"},{"key":"2025121408105335000_15.3.e076181.12","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"2025121408105335000_15.3.e076181.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13980-6","article-title":"Barriers and enablers of weight management after breast cancer: a thematic analysis of free text survey responses using the COM-B model","volume":"22","author":"Ee","year":"2022","journal-title":"BMC Public Health"},{"key":"2025121408105335000_15.3.e076181.14","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1111\/bjhp.12605","article-title":"Using the COM-B model to characterize the barriers and facilitators of pre-exposure prophylaxis (PrEP) uptake in men who have sex with men","volume":"27","author":"Madhani","year":"2022","journal-title":"Br J Health Psychol"},{"key":"2025121408105335000_15.3.e076181.15","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1111\/hex.13346","article-title":"Advancing understanding of influences on cervical screening (non)-participation among younger and older women: A qualitative study using the theoretical domains framework and the COM-B model","volume":"24","author":"O\u2019Donovan","year":"2021","journal-title":"Health Expect"},{"key":"2025121408105335000_15.3.e076181.16","doi-asserted-by":"publisher","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G"},{"key":"2025121408105335000_15.3.e076181.17","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2025121408105335000_15.3.e076181.18","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"2025121408105335000_15.3.e076181.19","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1111\/jocn.12681","article-title":"Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research","volume":"24","author":"Al-Amer","year":"2015","journal-title":"J Clin Nurs"},{"key":"2025121408105335000_15.3.e076181.20","article-title":"Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies","volume":"31","author":"Doughty","year":"2023","journal-title":"Support Care Cancer"},{"key":"2025121408105335000_15.3.e076181.21","first-page":"60","article-title":"Barriers to physical activity in prostate cancer survivors","volume":"134","author":"Patel","year":"2021","journal-title":"N Z Med J"},{"key":"2025121408105335000_15.3.e076181.22","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12206584","article-title":"What Really Matters to Survivors of Acute Type A Aortic Dissection-A Survey of Patient-Reported Outcomes in the Dutch National Aortic Dissection Advocacy Group","volume":"12","author":"Breel","year":"2023","journal-title":"J Clin Med"},{"key":"2025121408105335000_15.3.e076181.23","doi-asserted-by":"crossref","DOI":"10.1093\/jncics\/pkae068","article-title":"Cognitive function in long-term testicular cancer survivors: impact of modifiable factors","volume":"8","author":"Dinh","year":"2024","journal-title":"JNCI Cancer Spectr"},{"key":"2025121408105335000_15.3.e076181.24","first-page":"2185","article-title":"Exploring clinical determinants and anxiety symptom domains among Asian breast cancer patients","volume":"21","author":"Cheung","year":"2013","journal-title":"Support Care Cancer"},{"key":"2025121408105335000_15.3.e076181.25","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1001\/jamaoncol.2016.6914","article-title":"Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-analysis","volume":"3","author":"Mustian","year":"2017","journal-title":"JAMA Oncol"},{"key":"2025121408105335000_15.3.e076181.26","doi-asserted-by":"crossref","DOI":"10.1111\/ene.16452","article-title":"Education for fatigue management in people with multiple sclerosis: Systematic review and meta-analysis","volume":"31","author":"Wendebourg","year":"2024","journal-title":"Eur J Neurol"},{"key":"2025121408105335000_15.3.e076181.27","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19010287","article-title":"Perception and Performance of Physical Activity Behavior after Head and Neck Cancer Treatment: Exploration and Integration of Qualitative and Quantitative Findings","volume":"19","author":"Sealy","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025121408105335000_15.3.e076181.28","doi-asserted-by":"crossref","DOI":"10.1016\/j.pec.2023.107808","article-title":"Patients\u2019 perspectives of factors influencing active participation in healthcare interactions: A qualitative study","volume":"114","author":"Cvetanovska","year":"2023","journal-title":"Pat Educ Couns"},{"key":"2025121408105335000_15.3.e076181.29","doi-asserted-by":"crossref","DOI":"10.1186\/s12902-023-01268-8","article-title":"What is the effect of mobile phone text message reminders on medication adherence among adult type 2 diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"Belete","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"2025121408105335000_15.3.e076181.30","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-022-01170-z","article-title":"Nurse-led telehealth intervention effectiveness on reducing hypertension: a systematic review","volume":"22","author":"Kappes","year":"2023","journal-title":"BMC Nurs"},{"key":"2025121408105335000_15.3.e076181.31","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1017\/S1463423615000043","article-title":"Stigma as a barrier to diagnosis of lung cancer: patient and general practitioner perspectives","volume":"16","author":"Scott","year":"2015","journal-title":"Prim Health Care Res Dev"},{"key":"2025121408105335000_15.3.e076181.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-019-1271-3","article-title":"The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas","volume":"17","author":"Stangl","year":"2019","journal-title":"BMC Med"},{"key":"2025121408105335000_15.3.e076181.33","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgast-2021-000634","article-title":"Patient disease knowledge, attitudes and behaviours related to non-alcoholic fatty liver disease: a qualitative study","volume":"8","author":"Tincopa","year":"2021","journal-title":"BMJ Open Gastroenterol"},{"key":"2025121408105335000_15.3.e076181.34","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-022-02837-0","article-title":"Psychosocial barriers and facilitators for adherence to a healthy lifestyle among patients with chronic kidney disease: a focus group study","volume":"23","author":"Cardol","year":"2022","journal-title":"BMC Nephrol"},{"key":"2025121408105335000_15.3.e076181.35","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2021.104001","article-title":"Effects of peer support interventions on physical and psychosocial outcomes among stroke survivors: A systematic review and meta-analysis","volume":"121","author":"Wan","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"2025121408105335000_15.3.e076181.36","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.1993","article-title":"Patient perspectives on health-related behavior change after transient ischemic attack or ischemic stroke","volume":"11","author":"Brouwer-Goossensen","year":"2021","journal-title":"Brain Behav"},{"key":"2025121408105335000_15.3.e076181.37","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-172x.2002.00352.x"},{"key":"2025121408105335000_15.3.e076181.38","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s12529-020-09946-w","article-title":"Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors","volume":"28","author":"Silveira","year":"2021","journal-title":"Int J Behav Med"},{"key":"2025121408105335000_15.3.e076181.39","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ijom.2021.05.006","article-title":"Patients\u2019 views of physical activity whilst living with and beyond head and neck cancer","volume":"51","author":"Rogers","year":"2022","journal-title":"Int J Oral Maxillofac Surg"},{"key":"2025121408105335000_15.3.e076181.40","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/eurjcn\/zvab062","article-title":"Cardiovascular health in emerging adults with type 1 diabetes","volume":"21","author":"McCarthy","year":"2022","journal-title":"Eur J Cardiovasc Nurs"},{"key":"2025121408105335000_15.3.e076181.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2006.09.006"},{"key":"2025121408105335000_15.3.e076181.42","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1007\/s11764-023-01418-w","article-title":"Relationship between posttraumatic growth and help-seeking behavior in use of psychosocial support services among patients with cancer","volume":"18","author":"Matsui","year":"2024","journal-title":"J Cancer Surviv"},{"key":"2025121408105335000_15.3.e076181.43","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1002\/cpp.2838","article-title":"Posttraumatic growth in colorectal cancer survivors: A systematic review","volume":"30","author":"Wang","year":"2023","journal-title":"Clin Psychol Psychother"},{"key":"2025121408105335000_15.3.e076181.44","doi-asserted-by":"publisher","DOI":"10.1348\/135910708X332936"},{"key":"2025121408105335000_15.3.e076181.45","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1143-7"},{"key":"2025121408105335000_15.3.e076181.46","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1002\/pon.6241","article-title":"Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials","volume":"32","author":"Vrontaras","year":"2023","journal-title":"Psychooncology"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-076181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:11:07Z","timestamp":1765728667000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-076181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,5]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bmjopen-2023-076181"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-076181","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}