Su-Feng Yin, Fei-Fei Bian, Hai-Xia Li

Department of Orthopedics, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China

Correspondence: Hai-Xia Li, Department of Orthopedics, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China, Tel +86 0523-86820566, Email haixialilhx@163.com

Objective: This study aimed to investigate the status of negative information attentional bias, self-management, and health-promoting behaviors among patients with chronic refractory wounds receiving orthopedic care. Additionally, the study sought to construct a structural equation model (SEM) to evaluate the influence of negative attentional bias on self-management and health-promoting behaviors, with the intent of informing the clinical implementation of evidence-based health behavior education programs.
Methods: A total of 226 patients with chronic refractory wounds under orthopedic treatment at a single institution between January 2020 and December 2022 were enrolled in this study. Data were collected using a general information questionnaire, the Negative Cognitive Processing Bias Questionnaire, the Chronic Disease Self-Management Scale (CDSMS), and the Health-Promoting Lifestyle Profile II (HPLP-II). Pearson’s correlation analysis was conducted to assess associations among negative attentional bias, self-management, and health-promoting behaviors. SEM using Amos 21.0 was conducted to examine potential mediating effects.
Results: Health-promoting behaviors demonstrated a positive correlation with self-management and a negative correlation with negative attentional bias. Furthermore, self-management was negatively correlated with negative attentional bias (all p < 0.05). SEM indicated that negative attentional bias partially mediated the relationship between self-management and health-promoting behaviors, accounting for 31.65% of the total effect.
Conclusion: Negative attentional bias mediates the association between self-management and health-promoting behaviors among patients with chronic refractory wounds receiving orthopedic care. These findings suggest that enhancing self-management may improve engagement in health-promoting behaviors by reducing the influence of negative attentional bias.

Keywords: health-promoting behaviors, chronic refractory wounds, orthopedics, negative information attentional bias, structural equation modeling