Okube Okubatsion Tekeste, Kimani Samuel T
School of Nursing, The Catholic University of Eastern Africa, Nairobi, Kenya.
School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
SAGE Open Nurs. 2024 May 8;10:23779608241251658. doi: 10.1177/23779608241251658. eCollection 2024 Jan-Dec.
Evidence revealed that, 60% of deaths in the underdeveloped nations are linked to adoption of unhealthy lifestyles. The Trans-theoretical Model (TTM) has been considered a useful interventional approach in smoking cessation, drug addiction and weight control. However, its effectiveness in improving changes in dietary pattern, physical activity and alcohol consumption has not been reported.
The study aimed at evaluating the effectiveness of the TTM-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome.
This was an experimental design where 352 participants with metabolic syndrome were allocated to intervention and control groups. The participants were randomly assigned to receive either standard CVD care or a TTM stage-based lifestyle modification intervention for 12-months. Lifestyle patterns were assessed at baseline and endpoint. The mean difference of the subtotal TTM concept scores between pre and post intervention was evaluated using paired -test. The chi-square test of independence was used to detect between group differences in the categorical data.
Most of the participants were in the pre-action stage of change for their dietary intake patterns and physical activity habits at the baseline assessment with no difference between the groups. The intervention group's total level of change toward adopting a healthy lifestyle was markedly ( < 0.001) improved than the control group at the endpoint. The mean scores for the intervention group's stage of change, self-efficacy, and pros and cons of decisional balance all improved significantly ( < 0.001) from the baseline. The mean scores for the control group's pros and cons of decisional balance and stage of change also considerably ( < 0.05) improved from baseline to the endpoint.
The TTM- based health education intervention was effective in improving the participants' lifestyles that includes diet and physical activity. Health care providers, particularly nurses should implement TTM staged-matched educational intervention for individuals who are at risk for cardiovascular diseases.
有证据显示，在欠发达国家，60%的死亡与采用不健康的生活方式有关。跨理论模型（TTM）在戒烟、戒毒和体重控制方面被认为是一种有用的干预方法。然而，其在改善饮食模式、体育活动和饮酒方面变化的有效性尚未见报道。
本研究旨在评估基于跨理论模型的健康教育干预对促进代谢综合征成年人生活方式改变的有效性。
这是一项实验设计，将352名代谢综合征参与者分配到干预组和对照组。参与者被随机分配接受标准心血管疾病护理或基于跨理论模型阶段的生活方式改变干预，为期12个月。在基线和终点评估生活方式模式。使用配对t检验评估干预前后跨理论模型概念总分的平均差异。使用卡方独立性检验检测分类数据中的组间差异。
在基线评估时，大多数参与者在饮食摄入模式和体育活动习惯方面处于改变的前行动阶段，两组之间无差异。在终点时，干预组采用健康生活方式的总体变化水平比对照组显著提高（P<0.001）。干预组的改变阶段、自我效能以及决策平衡的利弊的平均得分均较基线显著提高（P<0.001）。对照组的决策平衡利弊和改变阶段的平均得分从基线到终点也有显著提高（P<0.05）。
基于跨理论模型的健康教育干预在改善参与者包括饮食和体育活动在内的生活方式方面是有效的。医疗保健提供者，尤其是护士，应为有心血管疾病风险的个体实施基于跨理论模型阶段匹配的教育干预。
