Application Of HBM And TPB Integration Theory In Functional Recovery Of Patients After Rotator Cuff Repair Under Arthroscopy

Objective The aim of this study was to construct an intervention program for patients undergoing arthroscopic rotator cuff repair based on the integration theory of health belief model and planned behavior;to investigate the effect of this program on the recovery of shoulder function in patients after rotator cuff injury,in order to improve postoperative patients’ compliance with rehabilitation exercises and promote the recovery of shoulder function.Methods The literature integrated the health belief model and the theory of planned behaviour by reviewing a large amount of domestic and international literature,and on this basis,a research group on the subject was established and 17 relevant experts were corresponded using the Delphi method to finally determine the intervention programme for postoperative rotator cuff injury.A convenience sampling method was used to select 68 patients with rotator cuff injury who were admitted to the sports medicine department of a tertiary hospital in Inner Mongolia from June 1,2022 to November 31,2022 according to the nadir criteria as the study population.The random number method was used to randomly assign the 68 patients to 34 cases each in the intervention and control groups.After excluding the dislodged subjects,63 study subjects were finally included,including 31 cases in the control group and 32 cases in the intervention group.The control group was given four one-to-one routine care sessions in the sports medicine department during hospitalisation by the charge nurse according to the clinical pathway for the care of patients with post-operative rotator cuff injury.The intervention group implemented a nursing intervention based on the integration theory of health beliefs and planned behaviours based on the control group,including 3 sessions during hospitalisation and for a period of 3 months after discharge.At the end of the intervention,the two groups were compared before and 1 and 3 months after the intervention by the Rehabilitation Exercise Adherence Scale,the Constant-Murley Scoring Scale for the Shoulder and the Visual Analogue Rating Scale for Pain,respectively.The data were analysed using statistical methods such as chi-square test,t-test,rank sum test and repeated measures analysis of variance using SPSS 26.0 software to evaluate the effectiveness of the intervention programme based on the integration of health beliefs and planned behaviour theory on the functional recovery of the shoulder joint in patients after arthroscopic rotator cuff repair.Results 1.two rounds of correspondence were conducted with 17 experts using the Delphi method.the positive coefficients of the two rounds of expert correspondence were 100% and100%,respectively;the authority coefficients of the experts were 0.89 and 0.92,respectively;the mean importance assignment of the entries was >3.5 and the coefficient of variation was<0.25.5 primary indicators,9 secondary indicators and 19 tertiary indicators were finally included.2.There was no statistical difference between the two groups in terms of general information,total and dimensional scores of rehabilitation exercise compliance,total and dimensional scores of shoulder joint,and visual analogue scores of pain before the intervention(P>0.05).At 1 and 3 months after the intervention,the total score of compliance with rehabilitation exercise and each dimension,the total score of shoulder joint and each dimension,and the visual analogue score of pain were all significantly higher in the intervention group compared with the control group(P<0.05),which was statistically significant.3.The time effect,between-group effect and interaction effect of the total score and each dimension score of rehabilitation exercise compliance,the total score and each dimension score of the shoulder joint before,1 month after and 3 months after the intervention were statistically significant in both groups(P<0.05).Conclusions 1.An intervention programme based on the integrated theory of HBM and TPB enhances postoperative rehabilitation beliefs and strengthens health behaviours in patients with rotator cuff injuries.2.The intervention programme based on the integrated theory of HBM and TPB can improve patients’ postoperative rehabilitation exercise compliance,improve their shoulder joint function and reduce pain.