A Trans-theoretical Model Based Health-promoting Behavior Intervention Study For Patients After Traumatic Spinal Cord Injury

Objective Through qualitative interviews with postoperative patients with traumatic spinal cord injury and related medical staff,the existing health behavior problems and influencing factors were discussed,and a preliminary health behavior intervention program was constructed.On the basis of the influencing factors of health behavior,combined with cross-theoretical model to guide the formulation of intervention program,and to evaluate the effect of the intervention program on health behavior score,willingness to change behavior,ability of daily life,quality of life,anxiety and depression in patients with traumatic spinal cord injury.Methods Study 1: using the method of key insider interviews,12 medical staff and 11 postoperative patients with traumatic spinal cord injury were interviewed to explore the current situation and influencing factors of health behavior of postoperative patients with traumatic spinal cord injury.Study 2: 111 patients with traumatic spinal cord injury who underwent surgery in the first affiliated Hospital of Anhui Medical University from December 2018 to December 2019 were randomly divided into control group(n = 56)and intervention group(n = 55).The control group received routine nursing: health education was given during hospitalization,guidance and telephone follow-up were given after discharge.The intervention group was treated with health behavior intervention based on cross-theoretical model,and the intervention effects of the two groups were compared and retested at 1,3 and 6 months after operation.repeated measurement analysis of variance was used to compare the willingness to change behavior,the level of healthy behavior,the ability of daily living,the degree of anxiety and depression and the quality of life between the two groups.Results Study 1: the health behavior problems of postoperative patients with traumatic spinal cord injury are mainly reflected in three aspects: lack of confidence and motivation,poor compliance and uneven ability to obtain information.The contributing factors of health behavior of postoperative patients with traumatic spinal cord injury are family,medical staff support,good medical compliance,contact with patients with the same disease,psychological nursing;the hindering factors of health behavior of patients with traumatic spinal cord injury are low cognitive level,weak willingness to change behavior,weakening interpersonal relationship,huge economic pressure and negative emotion.Study 2: there was no significant difference in baseline data,health behavior,willingness to change behavior,ability of daily life,degree of anxiety and depression and quality of life between the two groups before intervention(P<0.05.At 1,3 and 6months after operation,the health behavior and willingness to change in the intervention group were higher than those in the control group,and the scores of anxiety and depression in the intervention group were lower than those in the control group.The activities of daily life and quality of life in the control group were significantly higher than those in the control group at 3 and 6 months after operation(P<0.05).Conclusion The factors affecting the establishment of health behavior in postoperative patients with traumatic spinal cord injury are diversified,so it is necessary to formulate a systematic and comprehensive nursing intervention plan,which can improve the cognitive level of health information and the level of family support.reduce negative emotions,establish and maintain patients’ healthy behavior;The health behavior intervention program based on cross-theoretical model for postoperative patients with traumatic spinal cord injury not only has strong pertinence,but also can improve bad health behavior,urge the establishment and maintenance of health behavior,and reduce negative emotions such as anxiety and depression.enhance patients’ ability of daily life and improve their quality of life.