| Objective1.To construct an exercise behavior intervention program for osteoporosis patients based on the IMB model.2.To verify the application effect of the exercise behavior intervention program for osteoporosis patients based on the IMB model in the level of exercise knowledge,attitude and practice,exercise self-efficacy and self-management ability of osteoporosis patients.MethodThis study was divided into two parts.1.Construction of exercise behavior intervention program for osteoporosis patients guided by IMB modelLiterature research method was used to review the relevant literature on exercise status survey and intervention of osteoporosis patients,and to understand the exercise status and influencing factors of osteoporosis patients at home and abroad.The systematic evaluation literature,randomized controlled studies and investigation studies of exercise behavior and intervention for osteoporosis patients were reviewed,and the design and implementation of relevant intervention programs were analyzed.The first draft of exercise behavior intervention program for osteoporosis patients was constructed under the theoretical guidance of IMB model.The intervention program was modified and improved through two rounds of expert letter consultation and preliminary test.Finally,the exercise behavior intervention program for osteoporosis patients was formed.2.Application of IMB model exercise behavior intervention program for osteoporosis patientsFrom February to August 2022,130 patients with primary osteoporosis in a comprehensive Class ⅲ Grade A hospital in Suzhou were randomly divided into the control group(65 cases)and the intervention group(65 cases)by random number method.The control group was given routine nursing measures,and the intervention group implemented exercise behavior intervention program for osteoporosis patients based on IMB model on the basis of routine nursing measures.Result1.Construction of exercise behavior intervention program for osteoporosis patients in IMB modelThe exercise behavior intervention program for osteoporosis patients based on the IMB model in this study included three modules:information delivery stage,motivation construction stage and skill teaching stage.In the information delivery stage,there were four themes:disease knowledge,life style,drug treatment and exercise.In this stage,osteoporosis knowledge was mainly pushed for patients through wechat public account,and the intervention time was from the first to the fourth week,3 times a week,lasting for 4 weeks.The motivational construction stage included three motivational interviews,each of which lasted 15-30 minutes.In the first two days after admission,the researcher established a trust relationship with the patient,excavated the internal motivation conflicts of the patient,and developed an exercise behavior change plan.In the second interview,one day before discharge,the researcher helped the patient solve the difficulties encountered in the process of behavior change,and strengthened the patient’s confidence in behavior change and self-management of the disease.In the third interview,one month after discharge,the researchers investigated the implementation of the exercise plan and encouraged the patients to continue to adhere to it.The skill teaching stage included six themes:exercise methods,exercise time and frequency,exercise intensity,exercise principles,safety guidance and pain nursing.In this stage,relevant skills and precautions were taught to patients through a combination of online push of official accounts and offline demonstration by researchers.2.Application of DAB model exercise behavior intervention program for osteoporosis patientsA total of 130 patients with osteoporosis were included in this study,and 4 cases were lost to follow-up,with an attrition rate of 3%.The effective sample size was 126 cases.There were 63 cases in the intervention group and 63 cases in the control group.There was no statistically significant difference in the general data between the two groups(P>0.05),which was comparable.The results of patients’ exercise KAP score,self-efficacy score and self-management behavior score were as follows.The average scores of exercise knowledge,exercise behavior and exercise health belief in the intervention group were 4.10±1.30,25.63±6.42 and 37.59±3.90,respectively.In the control group,the average score of exercise knowledge was 3.83±1.14,the average score of exercise behavior was 25.52±6.70,and the average score of exercise health belief was 37.22±3.48.The average score of exercise self-efficacy was 47.47±4.66 in the intervention group and 47.91±4.24 in the control group.The average score of self-management behavior was 76.56±9.49 in the intervention group and 78.43±12.82 in the control group.There was no statistically significant difference in the scores between the two groups(P>0.05).Repeated measures ANOVA showed that:(1)There were statistically significant differences in the time effect,inter-group effect and interaction effect of exercise KAP scores between the two groups at different time points.The KAP scores of exercise in the intervention group were higher than those in the control group 1 month,3 months and 6 months after intervention,and the differences were statistically significant(P<0.05).With the extension of time,the score of exercise knowledge in the intervention group decreased slightly,and the score in the control group increased slightly.The scores of exercise behavior in the intervention group increased gradually,and the differences between 3 months and 6 months after intervention and 1 month after intervention were statistically significant(P<0.05),but there was no significant change in the control group.There was no significant change in the score of exercise health belief in the intervention group,while the score of the control group increased slightly and then decreased.(2)There were statistically significant differences in the intergroup effect,time effect and interaction effect of exercise self-efficacy scores between the two groups at different time points(Ftime=188.309,Fgroup=83.091,Finteraction=88.373).The exercise self-efficacy scores of the intervention group were higher than those of the control group at 1 month,3 months and 6 months after intervention,and the differences between each two time points were statistically significant(P<0.05).With the extension of time,the exercise self-efficacy of the intervention group continued to improve,reaching the highest level at 3 months after intervention,and then decreased,while the control group had no significant change.(3)There were statistically significant differences in the intergroup effect,time effect and interaction effect of the total score of self-management behavior between the two groups at different time points(Ftime=66.704,Fgroup=61.185,Finteraction=43.695,P<0.05).At 1 month,3 months and 6 months after intervention,the scores of self-management behavior and the scores of all dimensions in the intervention group were higher than those in the control group,and the differences were statistically significant(P<0.05).With the extension of time,the self-management behavior score of the intervention group was the highest at 3 months,and decreased at 6 months,and the self-management behavior score at 6 months after intervention was significantly different from that at 1 month and 3 months after intervention(P<0.05).The self-management behavior score of the control group increased slightly at 1 month and 3 months after intervention,and decreased at 6 months after intervention.Little overall change.Conclusion(1)The exercise behavior intervention program for osteoporosis patients based on the IMB model can significantly improve the KAP level of exercise in patients.(2)The exercise behavior intervention program for osteoporosis patients based on the IMB model can improve the exercise self-efficacy of patients.(3)The exercise behavior intervention program for osteoporosis patients based on the IMB model can improve the self-management ability of patients.(4)The exercise behavior intervention program for osteoporosis patients constructed based on the IMB model is scientific and feasible,which can provide reference for medical staff to conduct exercise behavior intervention for patients. |
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