Study On The Construction Of The Exercise And Diet Intervention Program For Elderly Patients With Frailty And Qi Deficiency In Community Based On The TTM

【Objective】Based on the previous research on the frailty of the elderly in the community conducted by our research team,by referring to domestic and foreign literature,semi-structured interview and expert letter consultation,the“the Exercise and Diet Intervention Program for Elderly Patients with Frailty and Qi Deficiency in Community Based on the TTM” was constructed.Under the background of global aging,this project,responding to the National Health China 2030 Plan and giving full play to the call of TCM health care policies,develops individualized exercise and diet intervention programs for the elderly,and provides a theoretical basis for the correction of biased constitution,the promotion of exercise and diet behavior transformation,and the improvement of frailty.【Methods】The descriptive qualitative method,systematic guidelines review method and Delphi expert letter consultation method were used in qualitative research.According to the interview outline,15 elderly patients with frailty and qi deficiency in Jinan community were selected for semi-structured interviews by the purpose sampling method,and the content analysis was used for analysis.System to retrieve the exercise and dietary interventions related to clinical practice guidelines,use AGREE Ⅱ for quality evaluation of into high quality evidence,forming the first draft of the intervention plans.According to the inclusion criteria,16 experts were selected to conduct two rounds of expert letter consultation on the preliminary draft of " Exercise and Diet Intervention Program for Elderly Patients with Frailty and Qi Deficiency in Community Based on the TTM " to form the final draft.【Results】1.Qualitative research results: The lack of relevant knowledge,the sense of disease uncertainty and the attitude of medical professionals affect the respondents’ attitude towards frailty and qi deficiency.The interviewees believe that behavior change is needed and there are difficulties in behavior change,so they hope to have professional guidance program.2.Recommended suggestions for exercise intervention in the frailty of the elderly in the community mainly include the importance of exercise,exercise mode,exercise type,exercise frequency and time.Recommendations for nutritional interventions include vitamin D supplementation where necessary,protein and calorie supplementation,and individualized intervention plans.Chinese medicine diet nursing.3.Results of Delphi expert letter consultation: After two rounds of expert letter consultation,“the Exercise and Diet Intervention Program for Elderly Patients with Frailty and Qi Deficiency in Community Based on the TTM” was constructed.The recovery rates of the two rounds of questionnaires were 100%and 93.75%,respectively.The expert authority coefficients of the two rounds of questionnaires were 0.908 and 0.856,respectively.After the first round of expert letter consultation,2 second-level indicators were merged,16third-level indicators were modified,3 third-level indicators were added and3 third-level indicators were deleted.After the second round of expert letter consultation,2 second-level indicators and 6 third-level indicators were modified.In the first round,the expert coordination coefficients of the importance of three-level indicators were 0.151,0.103 and 0.085,respectively,and the expert coordination coefficients of the feasibility of three-level indicators were 0.151,0.100 and 0.087,respectively.In the second round,the expert coordination coefficients of the importance of three-level indicators were 0.205,0.114 and 0.094,respectively,and the expert coordination coefficients of the feasibility of three-level indicators were 0.157,0.108 and 0.100,respectively,P < 0.05.【Conclusions】1.The attitude of community elderly patients with frailty and qi deficiency is affected by many factors.At the same time,they believe that it is necessary to make behavioral changes,but it is difficult to make behavioral changes,so they hope to get professional guidance.2.The " Exercise and Diet Intervention Program for Elderly Patients with Frailty and Qi Deficiency in Community Based on the TTM " constructed in this study is scientific,reliable and feasible.In this study,before the expert letter questionnaire was formed,relevant guide retrieval and high-quality evidence collection were carried out,which laid an evidence-based foundation for the construction of the scheme.In the early stage,the semi-structured interview was conducted to understand the understanding and experience of the elderly patients with frailty and qi deficiency in the community on the current state.The needs and wishes of the patients were fully considered,which laid a realistic foundation for the construction of the program.Finally,the“Exercise and Diet Intervention Program for Elderly Patients with Frailty and Qi Deficiency in Community Based on the TTM”,consisting of 6 first-level indicators,19 second-level indicators and 50 third-level indicators.