Application effect of behavioral intervention using the transtheoretical model of behavioral change on improving elderly patients’ adherence of fall prevention (基于跨理论模型的行为干预对提高老年患者预防跌倒依从性的效果研究)

Objective To explore the application effect of behavioral intervention using the transtheoretical model (TTM) of behavioral change on improving elderly patients’ adherence of fall prevention. Methods A convenience sampling of 231 hospitalized elderly patients from a tertiary class-one general hospital in Beijing. Cases (n=115) and controls (n=116) were randomized using random number table method. Controls were applied with common fall prevention practices, while the cases were applied with TTM method in addition to the common practices applied to the controls. Self-efficacy scores, numbers of patients with TTM intervention at each stage, fall prevention adherence scores, and times of falling were compared between cases and controls before intervention, at the end of 1 month, 3 months, and 6 months, respectively. Results Comparing to the control group, the case group had higher fall prevention self-efficacy scores (t=2. 348, P=0. 023; t=3. 592, P=0. 002; 7. 036; t=0. 002, P＜0. 001), better trend of behavioral change in every stage (Z=6. 032, P=0. 007; Z=9. 261, P＜0. 001; Z=16. 137, P＜0. 001), higher fall prevention adherence scores (t=4. 052, P=0. 001; t=6. 971, P＜0. 001; t=8. 105, P＜0. 001), at the end of 1 month, 3 months, and 6 months of intervention, respectively. And the case group had less times of falling (χ2=4. 930, P=0. 023; χ2=13. 870, P＜0. 001), at the end of 3 months, and 6 months of intervention. Conclusion Behavioral intervention based on TTM could effectively improve fall prevention self-efficacy level, increase fall prevention adherence, and decrease times of falling in elder patients. (目的 探讨基于跨理论模型的行为干预提高老年患者预防跌倒依从性的效果。方法 便利选取北京某三级甲等医院老年病房住院的老年患者231例, 按随机数字表法分为观察组(n=115)与对照组(n=116), 对照组采用常规护理干预, 观察组在对照组基础上应用跨理论模型进行干预, 观察比较两组患者干预前、干预后1个月末、干预后3个月末及干预后6个月末预防跌倒自我效能得分、跨理论模型各阶段人数、预防跌倒依从性得分及跌倒次数。结果 干预后1个月末、干预后3个月末及干预后6个月末观察组老年患者预防跌倒自我效能得分均高于对照组(t=2. 348, P=0. 023; t=3. 592, P=0. 002; 7. 036; t=0. 002, P＜0. 001), 各阶段行为改变的趋势均优于对照组(Z=6. 032, P=0. 007; Z=9. 261, P＜0. 001; Z=16. 137, P＜0. 001), 预防跌倒依从性得分高于对照组(t=4. 052, P=0. 001; t=6. 971, P＜0. 001; t=8. 105, P＜0. 001); 干预后3个月末及干预后6个月末观察组老年患者跌倒发生次数少于对照组(χ2=4. 930, P=0. 023; χ2=13. 870, P＜0. 001)。结论 基于跨理论模型的行为干预能有效提升老年患者跌倒自我效能水平, 提高老年患者预防跌倒的依从性, 降低老年患者跌倒发生次数。)