Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Patient Educ Couns. 2020 Feb;103(2):328-335. doi: 10.1016/j.pec.2019.09.007. Epub 2019 Sep 5.
To evaluate the effectiveness of a multicomponent intervention based on the Health Action Process Approach (HAPA) model to improve the self-management precursors of older adults with tuberculosis (TB).
A cluster-randomised controlled trial was conducted. Older adults with TB in the intervention communities received HAPA-based multicomponent interventions at the beginning of treatment and in the first and sixth months after treatment initiation, and those in the control communities received health education alone. Self-management precursors were measured at baseline and 1 week after each intervention.
Among 262 randomized patients, 244 (93%) completed the trial. Compared with the control group, self-management precursor scores for the intervention group increased significantly over time (β = 2.92, p < 0.001) in the following 3 precursors: behaviour belief (β = 0.35, p < 0.001), behaviour plan (β = 0.72, p < 0.001), and self-efficacy (β = 1.85, p < 0.001). Education was significantly associated with behaviour belief (β = 0.18, p < 0.05). Chronic comorbidity was significantly associated with behaviour plan (β=-0.26, p < 0.05).
Compared with single health education, the HAPA-based multicomponent interventions significantly improved the self-management precursor of older adults with TB.
This HAPA-based multicomponent intervention strategy may be a promising self-management mode for the routine health care of TB patients.
评估基于健康行动过程方法（HAPA）模型的多组分干预措施对提高老年肺结核（TB）患者自我管理前体的有效性。
采用集群随机对照试验。干预组中的老年 TB 患者在治疗开始时和治疗开始后的第 1 个月和第 6 个月接受基于 HAPA 的多组分干预，对照组仅接受健康教育。在基线和每次干预后 1 周测量自我管理前体。
在 262 名随机患者中，有 244 名（93%）完成了试验。与对照组相比，干预组的自我管理前体评分随时间显著增加（β=2.92，p<0.001），在以下 3 个前体中表现出明显增加：行为信念（β=0.35，p<0.001）、行为计划（β=0.72，p<0.001）和自我效能（β=1.85，p<0.001）。教育与行为信念显著相关（β=0.18，p<0.05）。慢性合并症与行为计划显著相关（β=-0.26，p<0.05）。
与单一健康教育相比，基于 HAPA 的多组分干预措施显著改善了老年 TB 患者的自我管理前体。
这种基于 HAPA 的多组分干预策略可能是一种有前途的 TB 患者常规医疗保健的自我管理模式。
