Combined With Nudge Strategies Under The Guidance Of Planned Behavior Theory,Construct Diet And Exercise Intervention Scheme For Enterostomy Patients

ObjectiveCombined with nudge strategies under the guidance of Planned Behavior Theory,Construct diet and exercise intervention scheme for enterostomy patients.To explore the effects of intervention programs of adding nudge strategies on promoting social cognitive variables,diet,exercise behavior.To study the clinical practice significance of this program in improving the quality of life of patients with enterostomy,provide reference for the application of nudge strategy in the field of health behavior and for the daily healthy diet and exercise management of enterostomy patients.Methods1.Establishment of diet and exercise intervention scheme for enterostomy patients:Systematic search of diet and exercise related guidelines,literature for colorectal cancer enterostomy patients.The quality of the guidelines and literatures that meet the inclusion criteria were be evaluated,Integrated best practice evidence.It provides evidence-based basis for the construction of intervention plan.After a group discussion,Combined with nudge strategies under the guidance of Planned Behavior Theory,constructed the first draft intervention scheme.15 experts in related fields were selected for Delphi method,modified intervention plans based on expert advices.Then 9 patients with enterostomy were selected for a preliminary trial,further improve the intervention regimen based on the feedback.Formed the final draft of diet and exercise intervention program for enterostomy patients.2.Application of diet and exercise intervention program in enterostomy patients: A total of 87 colorectal cancer enterostomy patients Which treated in the ostomy outpatient department of hospital in Qingdao from October 2021 to July 2022 were selected as the research objects of this study.Patients treated in the ostomy outpatient department of A were included in the control group.Patients who received treatment in the ostomy clinic of B during the same period were included in the intervention group.Forty-three patients were included in the control group and 44 in the intervention group.Control group received 12 weeks of outpatient routine guidance on healthy diet and exercise.On the basis of routine guidance,the intervention group received the dietary and exercise program,which combined with nudge strategies,under the guidance of Planned Behavior Theory.Dietary behavior,exercise behavior,social cognitive variables(attitude,subjective norm,perceived behavioral control,behavioral intention),BMI,quality of life were measured before intervention,at the 7th and 12 th week of intervention.SPSS 26.0was used for data analysis,and combined with the results of data analysis,the differences between the two groups were compared.Results1.Establishment of diet and exercise intervention scheme for enterostomy patients:Through systematic search,a total of 13 literatures were included in this study.The quality evaluation of the included literatures was high.Integrated and formed management team,management objectives,diet management,sports management,a total of 15 evidence.In the two rounds of Delphi method,the experts was high enthusiasm.The authority coefficient was a high degree.Kendall’s W values were 0.379 and 0.469,respectively.According to the feedback of the pre-trial patients,the scheme was modified to form the final draft of the intervention scheme.2.Application of diet and exercise intervention program in enterostomy patients:There were 41 patients in the intervention group and 42 patients in the control group.There was no statistically significant difference in baseline data between the two groups.(1)Eating behavior,social cognitive variables in Planned Behavior Theory: At the7 th and 12 th week of intervention,the dietary behavior indexes in the intervention group were significantly better than those in the control group.The scores of planned behavior theory questionnaire were significantly higher than those of control group(P<0.05).The scores of social cognitive variables at the 12 th week of intervention were significantly higher than those of the control group(P<0.05).(2)Exercise behavior,social cognitive variables in Planned Behavior Theory: At the7 th and 12 th week of intervention.The scores of planned behavior theory questionnaire were significantly higher than those of control group(P<0.05).The scores of social cognitive variables at the 12 th week of intervention were significantly higher than those of the control group,the exercise behavior indexes in the intervention group were significantly better than those in the control group(P<0.05).(3)Diet and exercise target reach rate: At the 7th and 12 th week of intervention.The rate of dietary compliance in the intervention group was higher than that in the control group(P< 0.05).At the 12 th week of intervention,the exercise compliance rate of intervention group was higher than that of control group(P < 0.05).(4)BMI: at the 7th and 12 th week of intervention,there was no significant difference in BMI between the two groups(P>0.05).(5)Quality of life: at the 7th and 12 th week of intervention,quality of life scores in the intervention group were significantly higher than those in the control group(P <0.05).Conclusions1.This study systematically searched the relevant guidelines and literature.Two rounds of expert correspondence were conducted.Finally,6 first-level entries,14second-level entries and 19 third-level entries were formed.2.Combined with nudge strategies under the guidance of planned behavior theory.It can improve the diet and exercise behavior of patients with enterostomy,improve the attitude,subjective norms,perceived behavioral control and behavioral intention in the theory of planned behavior.The intervention scheme improved the quality of life of the patients with enterostomy and had certain effectiveness.