Application Of ITHBC-based Nursing Intervention On Self-management Behaviors In Patients With Primary Osteoporosis

Objectives: A cross-sectional survey to understand the current status of patients with primary osteoporosis(POP)in terms of disease perception,health beliefs,level of social support and self-management behaviours and to analyse the factors influencing them,in order to provide a basis for the development of nursing intervention programmes;It also explores the effects of nursing interventions based on the Integrated Theory of Health Behaviour Change(ITHBC)on the illness perception,health beliefs,social support level and self-management behaviour of POP patients,and provides a theoretical basis and effective interventions for clinical nursing interventions for POP patients.Methods: This study includes the first part of the study on the current situation and factors influencing the self-management behaviour of primary osteoporosis patients and the second part of the study on the intervention of ITHBC-based nursing intervention on the self-management behaviour of primary osteoporosis patients.1.In the one phase,a convenience sampling method was used to select POP patients attending outpatient clinics or hospitalized in the Affiliated Hospital of Shaanxi University of Chinese Medicine and the Second Affiliated Hospital of Shaanxi University of Chinese Medicine as the study subjects.The General Information Questionnaire,Osteoporosis Knowledge Tests(OKT),Osteoporosis Self-Efficacy Scales(OSES),Social Support Rating Scale(SSRS)and the Osteoporosis Patient Self-Management Behavior Scale were used as the research tool to analyze the current status and influencing factors of disease perception,health beliefs,social support level and self-management ability of POP patients.2.In the second study phase,a total of 80 patients with POP who were admitted to the Orthopedic Hospital of the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January to April 2022 were selected and randomly divided into a control group and an intervention group,with the control group being given the care program of routine care,and the intervention group being integrated with the ITHBC-based nursing intervention.The ITHBC-based care intervention programme includes in-hospital and out-of-hospital measures to enhance disease awareness and health beliefs,improve self-management skills and competencies,and strengthen social support.The research instrument is the same as the survey study.Evaluation of the Self-Management Behaviour Scale for Patients with Osteoporosis before the intervention,at 1 month of discharge,at 3months of discharge and at 6 months of discharge.The SPSS 26.0 was used for statistical analysis of the data,and statistical methods included independent-samples T test,Chi-square goodness-of-fit test,multiple linear stepwise regression,and repeated measures ANOVA,etc.Results:1.There were 270 subjects in this cross-sectional survey,and the scores of OKT,OSES,SSRS and self-management behavior of POP patients were 13.73±3.09,66.69±9.25,37.21±3.86 and 25.39±4.76 respectively,indicating that the prevalence of OP patients in this area Osteoporosis knowledge level,osteoporosis self-efficacy,social support and self-management behaviors all need to be improved.2.The results of univariate analysis showed that the patients’ gender,age and medical diagnosis at admission were not statistically significant on the self-management behavior of POP patients(P > 0.05);the education level,occupation,type of home address and per capita monthly household income were statistically significant on the self-management behavior of POP patients(P < 0.05).3.The results of multiple linear regression analysis showed that the six variables of education level,OKT,SSRS and OSES score,occupation and family per capita monthly income were the main influencing factors affecting the self-management behavior of POP patients,and the significance test for the regression equation was F=36.151,P < 0.001.4.The OKT,OSES,SSRS and self-management behavior scores of POP patients in the two groups before the intervention were not statistically different(P > 0.05);The OKT,OSES and SSRS scores of POP patients in both groups were higher after the intervention than before the intervention(P < 0.05);The OKT,OSES and SSRS scores of patients in the intervention group were higher than those of the control group after the intervention(P <0.05).At post-intervention,at 3 months of discharge,and at 6 months of discharge,patients in the intervention group had higher scores on the Self-Management Behavior Scale and each dimension of its scale than the control group(P < 0.05);The results of repeated measures ANOVA showed that the time effects in the total score and each dimension score of self-management behavior were statistically different between patients with POP in the intervention and control groups(P < 0.05);Self-management behaviour sub-dimension scores and total scores were statistically different between the two groups of patients in terms of group effects(P < 0.05);There was an interaction between the time factor and the group intervention factor for the self-management behaviour sub-dimension scores and total scores of the two POP groups(P < 0.05).Conclusions:1.The self-management behavior of POP patients is at a poor level and needs to be improved,and relevant nursing intervention programs should be started as soon as possible to improve the self-management behavior of patients;2.The main factors affecting the self-management behavior of POP patients include education level,OKT,SSRS and OSES score,occupation and family monthly income per capita.Efficacy and social support level,formulate corresponding intervention plan,and then improve self-management behavior of patients;3.ITHBC-based nursing interventions can significantly improve the disease cognition level,osteoporosis self-efficacy level,and social support level of POP patients,and then promote the long-term efficacy of osteoporosis self-management behaviors.