| Object1.Through qualitative research,explore the obstructive factors in the self-management behaviors of stroke patients,identify the behaviors that need to be changed in the self-management of stroke patients,and use the COM-B model to analyze the interview results and give specific suggestions.2.According to the BCW theory,the qualitative research results were translated into targeted nursing intervention programs.To explore the effects of this intervention program on the level of self-management behavior,self-care ability of daily life,stroke prevention and treatment knowledge and rehabilitation self-efficacy of stroke patients.Method1.Qualitative research: With the COM-B model as the framework,23 patients with stroke were selected as research objects by the purpose sampling method,and semi-structured interviews were conducted to analyze the hindering factors in their self-management and give preliminary targeted suggestions.2.Intervention study: 65 inpatients with stroke in the Department of Neurology of a third Class A hospital were selected as the research objects by convenience sampling method,including 32 cases in the intervention group and 33 cases in the control group.The control group was given routine nursing,and the intervention group was added a transformational nursing intervention program based on BCW theory on the basis of routine nursing.Self-management level of stroke patients,self-care ability of daily life,stroke prevention and treatment knowledge and rehabilitation self-efficacy were used as evaluation indicators,and the intervention effect was evaluated at three time points before intervention,one month after intervention and three months after intervention.SPSS27.0 software was used for statistical analysis.Result1.Qualitative research results: According to the COM-B model,three self-management obstacles were extracted,which were:(1)ability factor:(1)lack of self-management knowledge,(2)weak awareness of self-management behavior change,(3)the influence of physical ability decline,(4)poor self-control ability,(2)opportunity factor:(1)Lack of access to information;(2)lack of family support;(3)poor social health culture;(4)low access to medical resources.(3)(1)self-regulation fatigue;(2)lack of planning;(3)negative emotional influence;(4)stigma influence;(5)weak sense of benefit from self-management.2.Results of the intervention study:(1)There was no statistical significance in the difference of general data between the two groups before intervention(P<0.05);(2)After intervention,the self-management behavior score of patients in the intervention group was higher than that of the control group at each evaluation time point,the difference was statistically significant(P<0.05).In addition to the dimension of life management,the total score and other dimensions showed interaction effect(P<0.05),and the self-management behavior score of patients in the intervention group increased more than that of the control group;(3)After intervention,the score of self-care ability of patients in the intervention group was higher than that in the control group at each evaluation time point,the difference was statistically significant(P<0.05),there was an interaction effect(P<0.05),the increase of self-care ability of patients in the intervention group was greater than that in the control group;(4)After intervention,the knowledge score of stroke prevention and treatment in the intervention group was higher than that in the control group at each evaluation time point,the difference was statistically significant(P<0.05),and there was an interaction effect(P<0.05).The increase of knowledge score of stroke prevention and treatment in the intervention group was greater than that in the control group;(5)After intervention,the score of rehabilitation self-efficacy in the intervention group was higher than that in the control group at each evaluation time point,the difference was statistically significant(P<0.05),and there was an interaction effect(P<0.05).The increase of rehabilitation self-efficacy score in the intervention group was greater than that in the control group.Conclusion1.Qualitative research results show that stroke patients have certain problems in ability,opportunity and motivation,and it is necessary to formulate targeted intervention programs to intervene them;2.Based on the qualitative research results,the transformational nursing intervention plan formulated by BCW theory can effectively improve patients’ self-management ability and self-care ability in daily life,significantly improve patients’ knowledge prevention and treatment level of stroke,and enhance patients’ rehabilitation self-efficacy. |
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