Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan.
Department of Nursing, College of Medicine, and Associate Vice President, Office of International Affairs, National Cheng Kung University 701, Tainan City, Taiwan.
Int J Nurs Stud. 2022 Feb;126:104137. doi: 10.1016/j.ijnurstu.2021.104137. Epub 2021 Nov 22.
Healthy behaviors can slow the progression of chronic kidney disease. Professional healthcare providers deliver education, physical exercise programs, motivation consultations, and stage-tailored strategies for improving health behaviors, but their effectiveness reported mixed. The helping relationships of significant others based on the transtheoretical model have been shown to be beneficial in facilitating and practicing health-promoting behaviors. However, few studies have examined the effects of helping relationships on health-promoting behaviors among patients with chronic kidney disease.
The aim of this study was to examine the effects of the intervention strategies of significant others in their helping relationships with patients to advance stages of exercise and diet behaviors, and to improve health-promoting lifestyles.
A randomized controlled study.
Two outpatient nephrology clinics in southern Taiwan.
Sixty participants in each of the two groups.
Patients were randomly assigned to either the intervention group (n = 60) whose significant others received strategies for helping relationships for 12 months, or the control group (n = 60). The Stage of Change of Exercise and Diet Behaviors, and Health Promoting Lifestyle Profile-II Chinese version were assessed at baseline and 3, 6, 9, and 12 months after receiving the helping relationship interventions tailored to stage of change from significant others.
Generalized estimating equation analyzes revealed that the intervention group, when compared to the control group, had significantly advanced stages of change in exercise and diet, and improvement in health-promoting lifestyle over time. Adult children and spouses were the most common significant others to help patients practice healthy behaviors, compared to previous studies where professional healthcare providers were the significant others.
Individualized plans for healthy behaviors should take into consideration patients' readiness for adopting stage-tailored strategies of helping relationships of significant others to adhere to the health-promoting lifestyle. To promote a healthier lifestyle, significant others, such as spouses and adult children, should be included in treatment programs.
健康行为可以减缓慢性肾脏病的进展。专业医疗保健提供者提供教育、体育锻炼计划、动机咨询以及针对改善健康行为的阶段定制策略，但他们的效果报告结果不一。基于跨理论模型的重要他人的帮助关系已被证明有利于促进和实践促进健康的行为。然而，很少有研究探讨重要他人的帮助关系对慢性肾脏病患者健康促进行为的影响。
本研究旨在检验重要他人在帮助关系中的干预策略对推进锻炼和饮食行为阶段以及改善健康促进生活方式的影响。
随机对照研究。
台湾南部的两家门诊肾脏病诊所。
每组 60 名参与者。
将患者随机分配到干预组（n=60）和对照组（n=60）。干预组的重要他人接受了为期 12 个月的帮助关系策略，对照组则不接受。在接受重要他人根据阶段变化定制的帮助关系干预后，分别在基线以及 3、6、9 和 12 个月时评估锻炼和饮食行为阶段变化以及健康促进生活方式概况-II 中文版。
广义估计方程分析显示，与对照组相比，干预组在锻炼和饮食行为的变化阶段以及健康促进生活方式的改善方面随时间推移有显著进展。与之前研究中专业医疗保健提供者是重要他人不同，成年子女和配偶是帮助患者实践健康行为的最常见的重要他人。
健康行为的个性化计划应考虑患者对采用针对阶段定制的重要他人帮助关系策略的准备情况，以坚持健康促进的生活方式。为了促进更健康的生活方式，应将配偶和成年子女等重要他人纳入治疗计划。
