基于 HAPA理论模型的健康行为干预方案在心脏起搏器植入术后患者中的应用 [中文引用][英文引用]

目的  探讨基于健康行动过程取向（health action process approach，HAPA）理论模型的健康行为干预方案在心脏起搏器植入术后患者中的应用效果。方法  采用便利抽样法，选取 2023 年 7 月— 2024 年 2 月北京某三级甲等综合医院心脏起搏器植入术后患者 154 例作为研究对象，按照随机数字表法分为对照组和试验组，两组分别为 77 例。对照组患者采用常规护理 + 肩关节功能锻炼指导手册和视频的干预方式，试验组患者采用常规护理 + 为期 3 个月的基于 HAPA 模型的健康行为干预方案。分别在干预前、干预 3 个月、出院后 6 个月应用康复运动依从性调查表、成年人健康自我管理能力测评量表对两组患者进行问卷调查，采用 6min 步行距离评价两组患者的心肺功能。结果  干预 3 个月、6 个月后试验组患者康复运动依从性、自我管理能力得分优于对照组，两组比较，差异具有统计学意义（均 P<0.05）；试验组患者出院后 6 个月 6min 步行距离（6-minutewalking distance，6MWD）较对照组长，两组比较，差异具有统计学意义（P<0.05）。结论  采用基于 HAPA 理论模型的健康行为干预方案可提高心脏起搏器植入术后患者运动依从性，改善自我管理能力和心肺功能。

Objective To explore the effect of a health behaviour intervention program based on health action process approach （HAPA）on patients after implantation of a pacemaker. Methods Convenience sampling was conducted to select 154 patients who had implantation of a pacemaker in our hospital as research subjects. A random table was used to divide the patients into a control group and an trial group, with 77 patients per group. Patients in the control group were treated with conventional care and issued with exercise brochures, while the patients in the trial group were treated with conventional care with a HAPA-based health behaviour intervention program for 3 months. Both groups were evaluated using the rehabilitation exercise adherence questionnaire and the adult health selfmanagement ability assessment scale before the intervention, at 3 and 6 months after the intervention. Cardiopulmonary function of the patients in both groups was assessed by 6-minute walk test. Results After 3 months and 6 months of intervention, the scores of rehabilitation exercise compliance and self-management ability of the patients in the trial group were better than those in the control group. The difference between the two groups was statistically significant（P<0.05）. Six months after discharge, the 6-minute walking distance（6MWD）of the patients in the trial group was longer than that of the control group, and the difference between the two groups was statistically significant（P<0.05）. Conclusion The health behaviour intervention program based on the HAPA enhances the exercise compliance in patients who were implanted with a pacemaker, as well as improves the self-management behaviour and cardiopulmonary function.