行为分阶段转变理论在社区高血压病人干预中的应用

目的 探讨行为转变理论在社区高血压病人干预中的作用.方法 采用系统抽样的方法,从4个社区中抽取240人.其中两个社区的120人为干预组,另两个社区的120人为对照组.干预组由护士在行为分阶段转变理论的引导下,对高血压病人进行为期6个月的干预,包括高血压相关知识宣传、饮食、锻炼.结果 经过6个月的干预后两组之间在摄盐量、食用肉量、食用油量及锻炼方面均存在差异(P＜0.05),在收缩压、舒张压、腰围、体重指数方面也存在差异(P＜0.05).结论 以行为分阶段转变理论为指导,对社区高血压病人进行干预是可行的、有效的.     

行为分阶段转变理论模式对肾结石手术患者术后康复及健康行为的影响

目的 分析行为分阶段转变理论（TTM）模式对肾结石（RC）手术患者术后康复及健康行为的影响。方法 回顾性分析2019年9月至2021年9月医院51例采用常规模式护理干预的RC手术患者临床资料（包括随访资料）,作为对照组;另收集同期医院51例采用常规及TTM模式护理干预的RC手术患者临床资料（包括随访资料）,作为观察组。比较两组术后康复情况、健康行为、复发情况、并发症发生情况。结果 与对照组比较,观察组术后首次下床、拔出造瘘管及总住院时间均较短,差异有统计学意义（P<0.05）;与干预前比较,两组干预3个月后健康行为评分均升高,且观察组升高更为显著,差异有统计学意义（P<0.05）;观察组复发率、并发症发生率均低于对照组,差异有统计学意义（P<0.05）。结论 TTM模式护理干预可缩短RC手术患者术后康复时间,促进患者健康行为,且复发率低,并发症少。     

行为分阶段转变理论对乳头凹陷者母乳喂养的影响

目的：探索建立在行为分阶段转变理论模型上的母乳喂。养教育对乳头凹陷者母乳喂养的效果。方法：选择在台州市中心医院孕妇学校培训的乳头凹陷孕妇120例,按随机数字表法分为干预组和对照组,每组各60例。干预组采用建立在行为分阶段转变理论模型上的母乳喂养教育作为干预手段,对照组采用常规手段。分别比较两组孕妇在产后3～5天、42天、4个月及6个月的母乳喂养率。结果：干预组分别为91．7％、88．3％、81．7％及48．3％,对照组分别为78．3％、68．3％、58．3及30．0％,两组各时间段的差异均具有统计学意义（P〈O．05）。结论：应用行为分阶段转变理论模型上的母乳喂养教育可有效提高乳头凹陷者的母乳喂养率。     

行为转变理论模式与艾滋病行为干预

由艾滋病病毒(HIV)感染引起的艾滋病(AIDS)是一种新的传染病,自1981年世界第1例被报道以来,它的流行与危害以及所造成的严重后果已日益引起全世界的广泛重视.艾滋病与人类历史上曾经肆疟一时的天花、麻疹、脊髓灰质炎等其他传染病不同,目前尚无有效的疫苗和彻底治疗方法.全世界对此已达到的共识是,在可以预见的将来,同艾滋病作斗争的最大希望在于帮助人们选择比较安全的行为,以使他们不那么容易感染和传播艾滋病病毒 [1].     

分阶段转变理论护理对产妇母乳喂养知识及母乳喂养自我效能的影响

目的探讨分阶段转变理论护理对产妇母乳喂养知识及母乳喂养自我效能的影响。方法132例产妇依据护理干预方案的不同分为对照组(常规护理模式,66例)与观察组(分阶段转变理论护理模式,66例),比较两组产妇干预前后的母乳喂养知识掌握情况及自我效能。结果干预后,观察组产妇的喂养姿势、含接姿势、托乳姿势及挤奶手段评分,以及母乳喂养自我效能评分均显著高于对照组(P<0.05)。结论分阶段转变理论护理模式可有效提高产妇的母乳喂养知识水平及自我效能。     

行为转变理论应用于运动自我管理的研究

目的：探讨行为转变理论在运动自我管理中的应用。方法将301人分为实验组和对照组,实验组实施以行为转变理论为基础的干预模式,对照组未进行干预。两组在干预前后进行运动行为情况测评。结果实验组前意向期由31.13%下降到5.96%,意向期由38.41%下降到22.52%,准备期从18.54%上升到34.44%,行动期从8.61%上升到29.80%,维持期从3.31%上升到7.28%。除维持期外,实验组干预前后比较差异均有统计学意义（P〈0.05）。对照组各阶段干预前后比较差异均无统计学意义（P〉0.05）。结论行为转变理论在提高运动自我管理中有积极促进作用。     

分阶段转变护理对糖尿病肾病患者血糖控制、肾功能及自护行为的影响

目的 探讨分阶段转变护理对糖尿病肾病患者血糖控制、肾功能及自护行为的影响。方法 选取福州市某医院2019年6月—2020年8月收治的70例糖尿病肾病患者为研究对象,采用随机数字表法分为对照组(35例)和观察组(35例)。对照组患者给予常规护理干预,观察组患者在对照组护理基础上给予分阶段转变护理干预,2组患者均持续护理24周。比较2组患者护理前后的血糖控制情况、肾功能、自护行为评分。结果 护理前,2组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平比较,差异均无统计学意义(P>0.05);护理后,2组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于护理前,且观察组低于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者血清肌酐(Cr)、尿素(URE-A)、血清胱抑素C(Cys C)水平比较,差异均无统计学意义(P>0.05);护理后,2组患者血清Cr、URE-A、Cys C水平均低于护理前,且观察组低于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者总体饮食、具体饮食、运动、血糖监测、足部护理、吸烟各维度评分比较,差异均无统计学意义(P>...     

行为转变理论模式在“五小”行业监管中的应用

雨花台区地处南京主城西南,属城郊结合区域,区内小餐饮店、小理发店、小旅店、小浴室、小歌舞厅(五小)单位众多,安全隐患突出,风险控制难度大.“五小”行业卫生监管一直是该区卫生监督的工作重点,亦是创建国家卫生城市和文明城市的难点工作.如何提高“五小”行业从业人员的卫生素养,加强行业自身卫生管理,对于提升卫生监督管理整体水平,保障消费者身体健康都具有十分重要的意义.该文对雨花台区以行为转变理论模式指导“五小”行业卫生监管工作并取得较为明显的成效的实践进行了介绍.     

行为转变理论在住院患者口腔卫生健康教育中的应用

目的 探究分析行为转变理论在住院患者口腔卫生健康教育中的应用效果和价值.方法 抽取120例住院患者纳入本组研究,均分为两组,展开不同护理形式的分组探讨.对照组(60例)患者采取常规住院护理,观察组(60例)患者采取基于行为转变理论的护理方案.对比两种不同护理方式对应患者的口腔卫生护理成效以及健康教育的效果.结果 ①护理...     

Patients' readiness for dietary change at the beginning of counselling: a transtheoretical model-based assessment

Background The purpose of this study was to explore patients' readiness for dietary change within a theoretical framework of the transtheoretical model. The patients were recently diagnosed to have type 2 diabetes or impaired glucose tolerance. We discuss the theoretical aspects of appropriate dietary counselling strategies from a standpoint of patient‐specific stages of change. Methods The data included 32 audiotaped diabetes counselling sessions with 16 patients conducted by two nurses. The transcribed data was analysed by using deductive content analysis. Results The patients were at different stages of change of diabetes‐affected dietary behaviour. Their stages of change varied in different dietary areas and within certain dietary habits. These stages of change could involve their overall dietary behaviour or some minor aspects of their diets. Conclusions Understanding patient‐specific stages of change orientates health counsellors to use the most appropriate counselling strategies. The transtheoretical framework helps counsellors to perceive the total range of patients' different stages of change and their effect on the implementation of counselling. However, determining patients' stages of change through examining counselling conversations is occasionally difficult. Further qualitative research is called for.     

Sustainable transportation stage of change,decisional balance,and self-efficacy scale development and validation in two university samples

Single occupancy vehicle (SOV) transportation is a key contributor to climate change and air pollution. Sustainable transportation (ST), commuting by any means other than SOV, could both slow climate change and enhance public health. The transtheoretical model (TTM) provides a useful framework for examining how people progress towards adopting ST. Short valid and reliable measures for ST decisional balance, self-efficacy, and climate change doubt were developed and their relationship with stages of change was examined. Two large university-based volunteer samples participated in measurement studies. Using multiple procedures, three brief internally consistent measures were developed: decisional balance, self-efficacy, and climate change doubt. The stages of change correctly discriminated both decisional balance and self-efficacy, as well as replicated hypothesized relationships. Climate change doubt did not vary by stages; however, it may prove useful in future studies. Results support the validation of these measures and the application of the TTM to ST.     

Food safety knowledge and practice by the stages of change model in school children

In this study, 342 grade 4-6 elementary school students in Gyeonggi-do were recruited to determine their readiness to change food safety behavior and to compare their food safety knowledge and practices by the stages of change. The subjects were divided into three stages of change; the percentage of stage 1 (precontemplation) was 10.1%, the percentage of stage 2 (contemplation and preparation) was 62.4%, and that of stage 3 (action and maintenance) was 27.5%. Food safety knowledge scores in stage 3 (4.55) or stage 2 (4.50) children were significantly higher than those in stage 1 children (4.17) (P < 0.05). The two food safety behavior items "hand washing practice" and "avoidance of harmful food" were significantly different among the three groups (P < 0.05). Stages of change were significantly and positively correlated with food safety knowledge and practice. Age was significantly and negatively correlated with the total food safety behavior score (r = -0.142, P < 0.05). The most influential factor on the stage of change was a mother''s instruction about food safety (P < 0.01).     

Processes underlying young women''s decisions to eat fruits and vegetables

OBJECTIVE: To relate the use of identified processes that college women use to eat enough fruits and enough vegetables to their stages of readiness to change and their fruit and vegetable (F/V) intakes. METHOD: A cross-sectional assessment of college women 18-24 years of age (n = 236) was conducted to assess stage of readiness to eat F/V. Use of seven processes, earlier confirmed in a separate sample of college students the same age (health concerns, self-reevaluation, social liberation, health commitment/action, interpersonal control, external reinforcement and helping relationships) was compared with stage of change for F/V and 3 days of dietary intakes. RESULTS: In these young college women, use of self-reevaluation, a cognitive process for change, peaked in the preparation stage for both F/V. Use of health commitment/action, a post-action process including counter-conditioning, peaked in those in action/maintenance for F/V. Weight concerns related to the counter-conditioning processes women used to eat more fruit. CONCLUSION: Health practitioners should focus on weight management, appearance and health benefits of eating fruits and vegetables for this demographic group.     

An Exploratory study of compliance with dietary recommendations among college students majoring in health-related disciplines: application of the transtheoretical model

Compliance with food group and nutrient recommendations, and self-efficacy, stage of change, perceived barriers and benefits for healthy eating were assessed among a convenience sample of college students majoring in health-related disciplines. Dietary and psychosocial data were collected using three-day food records and scales, respectively. Means (SD), frequencies, and percents were calculated on all data, and logistic regressions were used to determine whether any of the psychosocial correlates predicted the stage of change for healthy eating. Noncompliance with food group recommendations ranged from 53% for the meat/meat alternates group to 93% for the vegetables/juice group, whereas noncompliance with nutrient recommendations ranged from 26% for cholesterol to 99% for potassium. A majority of students (57%) self-classified in the preaction and 40% in the action stages of change for eating healthy. The students'' self-efficacy to eat healthy was highest in positive/social situations and lowest when experiencing emotional upset. The most important perceived barrier to healthy eating was that friends/roommates do not like to eat healthy foods, and the most important perceived benefit was that eating healthy foods provides the body with adequate nutrients. The difficult/inconvenient self-efficacy subscale predicted the stage of change for healthy eating. These students would benefit from interactive learning opportunities that teach how to purchase and prepare more whole grain foods, fruits, and vegetables, enhance their self-efficacy for making healthy food choices when experiencing negative emotions, and overcome perceived barriers to healthy eating.     

Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa

OBJECTIVE: To determine if readiness for change (RFC) at admission predicted length of stay (LOS) and short-term outcomes among female adolescents in residential treatment for anorexia nervosa (AN). METHOD: Using a prospective cohort design to collect data from participants (N = 65) at admission and discharge, Kaplan-Meier survival analysis and Cox regression tested whether RFC on admission predicted time in LOS to a favorable short-term outcome--a composite endpoint based on minimum criteria for weight gain, drive for thinness, depression, anxiety, and health-related quality of life (HRQOL). RESULTS: Participants with low RFC had a mean survival time to a favorable short-term outcome of 59.4 days compared to 34.1 days for those with high RFC (log rank = 8.44, df = 1, p = .003). The probability of a favorable short-term outcome was 5.30 times greater for participants with high RFC. CONCLUSION: Readiness for change is a useful predictor of a favorable short-term outcome and should be considered in the assessment profile of patients with AN.     

结构变动度在住院费用构成变动分析中的应用

目的 探讨住院费用构成变动,防止人均住院费用过快增长.方法采用结构变动度和环比增长速度指标,分析6年来费用构成变动的情况.结果费用构成变动比较合理,诊疗费、手术费是引起住院费用结构变动上升的主要费用项目,2者的累积贡献率达到45.2%,护理费结构变动增幅较慢,贡献率仅为2.5%,说明在体现医生技术服务价值的同时,也应适当提高护理人员的技术服务价值;床位费、检查费、其他费是引起住院费用结构变动下降的主要费用项目,3者的累积贡献率达到47.6%,说明我院优化了收费结构,增强了管理意识.结论我院人均住院费用呈逐年缓慢增长趋势,与当地的经济发展水平相适应,优化了收费结构,体现了医院＂以病人为中心、提高治疗含金量＂的服务宗旨.     

Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam,South Korea: Comparison According to Stages of Behavioral Change

With the increase in meals eaten outside the home, sodium reduction in restaurant foods is essential for reducing sodium intake. This study aimed to assess the stages of behavioral change for reducing sodium and the differences in perceptions among restaurant staff by stage. Restaurant owners and cooks (n = 313) in Seongnam, South Korea were surveyed on their stage of behavioral change, practices, and perceptive factors related to sodium reduction in restaurant meals using a questionnaire. The proportion of behavioral change by stage was 20.4% in the maintenance and action (MA) stage, 32.3% in the preparation (P) stage, and 47.3% in the pre-preparation (PP) stage, which included contemplation and pre-contemplation stages. The items that represent differences among the groups were recognition of social environment for sodium reduction, practice of weighing condiments and measuring salinity, and feasibility of actions related to low-sodium cooking. Logistic regression analysis was used to estimate odds ratios for practice and perceptive factors by using stage of behavioral change as the independent variable. Factors associated with being in the MA stage were weighing condiments, measuring salinity, and high feasibility of actions related to low-sodium cooking. Recognition of sodium labeling and anticipation of better taste by reducing sodium increased the odds of being in the P stage rather than the PP stage. These results suggest that customized stepwise education and support are needed for the efficacy of restaurant-based sodium reduction programs.     

公共财政职能转变对卫生发展的机遇和挑战

我国政府公共财政职能正在逐步实行三大转变,即宏观上合理配置资源的职能,收入再分配职能和稳定社会的职能,卫生发展必须抓住机遇,利用卫生事业在政府实现上述三大职能中的特殊作用,以争取更大的政府投入。