助推理论在慢性病自我管理中的应用现状与推广建议

Nudge Theory in Chronic Disease Self-management:Advances in Application and Recommendations for Promotion

助推理论是一种建立在行为经济学和积极心理学之上的新兴行为干预理论,目前已在国外慢性病患者自我管理领域得到广泛应用,且干预效果明显。相对于传统的慢性病自我管理干预手段,基于助推理论构建的干预方案对慢性病患者自我管理的知识和态度要求不高,且不干涉慢性病患者的选择自由,可推广性较强。本文介绍了助推理论的概念、作用机制和分类,并从症状监测、饮食控制、体育锻炼、遵医嘱用药4个方面综述了助推理论在慢性病自我管理中的应用。在此基础上,建议未来基于助推理论的干预方案从患者自我管理的阻碍因素出发,结合数字化信息技术对患者进行分类干预,干预过程中与社区建立密切联系,并加强相关部门的监管以保证干预效果。

Nudge theory is an emerging behavioral intervention theory based on behavioral economics and positive psychology,which has been widely used and proven effective in chronic disease self-management abroad.Compared with traditional intervention methods for chronic disease self-management,nudge theory-based intervention program possesses stronger generalization owing to lower requirements for patients'knowledge and attitude regarding chronic disease selfmanagement without interfering with their freedom of choice.We introduced the concept,mechanism of action and classification of nudge theory,and reviewed the advances in its application in chronic disease self-management from four aspects:symptom monitoring,diet control,physical exercise,and medication adherence.On this basis,we put forward the following recommendations to ensure the effectiveness of nudge theory-based interventions:developing nudge theory-based intervention programs targeting the barriers to chronic disease self-management,delivering different types of interventions to different patients using digital technology as a method for classifying the intervention program,having close contact with the community during the intervention,and strengthening the supervision of relevant departments.