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基于健康行为改变整合理论(ITHBC)的综合护理干预对老年放疗患者多维健康指标纵向影响的验证

Validation of the Longitudinal Effect of an Integrated Nursing Intervention Based on the Integrated Theory of Health Behavior Change (ITHBC) on Multidimensional Health Indicators in Older Radiotherapy Patients.

作者信息

Jiang Jing, Qian Luxi, Chen Jie, Lu Juan, Zhu Huanfeng, Zhang Bo, Zhao Yalan, Tian Jing, Zhang Qiuping, He Xia

机构信息

The Affiliated Cancer Hospital of Nanjing Medical University, Department of Radiotherapy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu Province, People's Republic of China.

出版信息

Clin Interv Aging. 2025 Aug 22;20:1293-1304. doi: 10.2147/CIA.S532913. eCollection 2025.

Abstract

INTRODUCTION

The Integrated Theory of Health Behavior Change (ITHBC) offers a structured framework for promoting sustained health behavior change through cognitive beliefs, self-regulation, and social facilitation. However, its application in geriatric oncology remains unexplored.

METHODS

This quasi-experimental study enrolled 291 older adult patients who underwent radiotherapy at the Jiangsu Cancer Hospital. Patients hospitalized from July to December 2024 (n=146) received ITHBC-guided multidisciplinary nursing intervention, while those treated from January to June 2024 (n=145) received conventional individualized nursing care. Key outcomes, including disease cognition, self-management efficacy, and quality of life, were assessed at baseline and five months post-intervention using validated instruments. Statistical analyses included t-tests, ANCOVA, and effect-size calculations.

RESULTS

After 5 months, the intervention group showed significantly greater improvements in disease cognition (Δ=+23.5 vs +16.4), self-management efficacy (Δ=+10.63 vs +3.77), and quality of life scores (Δ=+22.07 vs +6.98), all P < 0.001. The effect size for disease cognition was 1.32 (95% CI: 1.08-1.56).

DISCUSSION

These findings confirm the efficacy of the ITHBC-based nursing model in enhancing cognitive, behavioral, and psychosocial outcomes in older patients undergoing radiotherapy. Structuring geriatric oncology care around behavioral theories, such as ITHBC, yields measurable benefits and supports its broader application in nursing interventions.

摘要

引言

健康行为改变综合理论(ITHBC)提供了一个结构化框架,通过认知信念、自我调节和社会促进来推动持续的健康行为改变。然而,其在老年肿瘤学中的应用仍未得到探索。

方法

这项准实验研究纳入了291名在江苏省肿瘤医院接受放疗的老年患者。2024年7月至12月住院的患者(n = 146)接受了ITHBC指导的多学科护理干预,而2024年1月至6月接受治疗的患者(n = 145)接受了传统的个体化护理。在基线和干预后五个月,使用经过验证的工具评估了包括疾病认知、自我管理效能和生活质量在内的关键结果。统计分析包括t检验、协方差分析和效应量计算。

结果

5个月后,干预组在疾病认知(Δ = +23.5对+16.4)、自我管理效能(Δ = +10.63对+3.77)和生活质量评分(Δ = +22.07对+6.98)方面均有显著更大的改善,所有P < 0.001。疾病认知的效应量为1.32(95%CI:1.08 - 1.56)。

讨论

这些发现证实了基于ITHBC的护理模式在改善接受放疗的老年患者的认知、行为和心理社会结果方面的有效性。围绕ITHBC等行为理论构建老年肿瘤护理,会产生可衡量的益处,并支持其在护理干预中的更广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b127/12379990/538ecd49c009/CIA-20-1293-g0001.jpg

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