基于应用健康行为过程取向理论的干预方案对老年心力衰竭患者久坐行为影响研究

Effect of Intervention on Reducing Sedentary Behavior in Elderly Patients with Heart Failure Based on HAPA Theory

目的探讨应用健康行为过程取向(health action process approach,HAPA)理论的干预方案对减少老年心力衰竭(heart failure,HF)患者久坐行为的护理效果。方法2023年8-10月,便利抽样法选取江苏省某三级甲等医院心血管内科住院的老年HF患者为研究对象,根据病区,将心内科1病区设为对照组,5病区设为干预组,每组各36例;对照组给予常规健康教育,干预组在常规健康教育基础上实施基于HAPA理论的护理方案;分别于4个节点:干预前、出院后2周、1个月、3个月,比较两组久坐行为每日总时间和单次最长时间、每日总步数、步行速度以及自我效能的变化。结果干预组出院后1个月、3个月每日总时间和单次最长时间低于对照组,而每日总步数和自我效能评分均高于对照组,出院后3个月步行速度评分也高于对照组(均P<0.05)。结论基于HAPA理论的护理干预方案能减少老年HF患者久坐行为,同时提升患者活动自我效能。

Objective To explore the effect of nursing intervention using health action process approach(HAPA)theory on reducing sedentary behavior in elderly patients with heart failure(HF).Methods From August to October 2023,72 elderly patients with HF were selected by convenience sampling,and evenly grouped into a control group(patients in section 1 of ward)and an intervention group(patients in section 5 of ward).The former was given routine health education,and the latter a nursing plan based on HAPA theory in addition to the routine one.Figures of daily sedentary period,single maximum sedentary length,daily step count,walking speed and self-efficacy of the two groups were compared before the intervention,2 weeks,1 month and 3 months after discharge respectively.Results The daily sedentary period and single maximum length of the intervention group were significantly lower than those in the control group in 1 and 3 months after discharge,while the daily step count and self-efficacy scores were significantly higher than those in the control group,and the walking speed score in 3 months after discharge was also significantly higher than that in the control group(P<0.05).Conclusions The nursing intervention plan based on HAPA theory can reduce the sedentary behavior of elderly patients with HF and improve their self-efficacy on activity.