A Study On The Effect Of Health Education Based On The Theory Of Protective Motivation On The Self-management Behavior Of Older Adults With Osteopenia In The Community

Objective:To explore the effects of health education based on the theory of protective motivation on objective indicators such as bone mineral density,fear of disease progression,self-efficacy,self-management behaviors and quality of life in older adults with osteopenia in the community,with the aim of providing a reference for the development of a health education program on self-management behaviors in older adults with osteopenia in the community.Methods:A convenience sampling method was used to select 70 older adults with osteopenia in Dongfeng and Yan’an communities in Bengbu,with Dongfeng community as the intervention group and Yan’an community as the control group,with 35 people in each group.Both groups received routine health education management in the community,on which the intervention group carried out health education strategies based on the theory of protective motivation,including:health lectures,pedal exercises and walking,personalized guidance,sharing and exchange sessions,WeChat education.And objective indicators such as bone mineral density,fear of disease progression,self-efficacy,self-management behavior and quality of life were measured before the intervention,12 weeks of intervention and 12 weeks of follow-up in the elderly with osteopenia.Descriptive statistical analysis,chi-square test,t-test,nonparametric rank sum test,and repeated measures ANOVA were used P<0.05 was considered a significant difference.Results:1.During the intervention,there was 1 case of loss to follow-up in the control group（visiting relatives）,and 69 elderly people were finally intervened,including 35 in the intervention group and 34 in the control group.2.physiological indexes:①Bone density indexes:SI（bone strength）and T-value（bone density）in the intervention group at 12 weeks of intervention and 12 weeks of follow-up,compared with those before intervention,showed statistically significant differences（P<0.05）.The differences in SI（bone strength）and T-value（bone density）at 12 weeks of intervention and 12 weeks of follow-up were statistically significant（P<0.05）in both groups compared with each other.②Body composition index:There was no statistically significant difference in BMI and muscle mass between the two groups at different time points（P>0.05）.③Cardiovascular index:the differences in SBP（systolic blood pressure）in the intervention group were statistically significant（P<0.05）when compared at different time points.The differences in DBP（diastolic bloo pressure）and CAP（central arterial pressure）in the intervention group at 12 weeks of intervention and 12 weeks of follow-up were statistically significant（P<0.05）compared with those before the intervention.The differences in CAP（central arterial pressure）at 12 weeks of intervention were statistically significant（P<0.05）compared with the two groups;the differences in mean values of SBP（systolic blood pressure）,DBP（diastolic blood pressure）,CAP（central arterial pressure）,SEVR（subendocardial myocardial viability rate）,and the value of PWV（pulse wave velocity）at 12 weeks of follow-up were statistically significant（P<0.05）.3.Physical fitness indexes:The differences in the time to select response and time to stand on one foot with eyes closed at 12 weeks of intervention in the intervention group were statistically significant（P<0.05）compared with those before the intervention;the differences in the time to select response at 12 weeks of follow-up were statistically significant（P<0.05）compared with those before the intervention.There was a statistically significant difference（P<0.05）in the time of standing on one foot with eyes closed at 12 weeks of intervention compared to the two groups.4.Average daily steps:The average daily steps of the elderly in the intervention group showed an overall increasing trend during the intervention period,and although the average daily steps decreased during the follow-up period,they all exceeded 7500 steps/day,meeting the requirement of daily activity steps for the elderly.5.Subjective perception:The fear of disease progression and self-efficacy of the elderly in the intervention group at 12 weeks of intervention and 12 weeks of follow-up were significantly improved compared with those before the intervention（P<0.05）,and the improvement was significantly better than that of the control group（P<0.05）.6.Self-management ability:The self-management ability of the elderly in the intervention group at 12 weeks of intervention and 12 weeks of follow-up was significantly improved compared with that before the intervention（P<0.05）,and the improvement was significantly better than that of the control group（P<0.05）.7.Quality of life:The quality of life of the elderly in the intervention group at 12 weeks of follow-up was significantly improved compared with that before the intervention（P<0.05）,and the improvement was significantly better than that of the control group（P<0.05）.Conclusion:Health education based on the theory of protective motivation can significantly improve objective indicators such as bone density in older adults with osteopenia in the community,while reducing fear of disease progression,enhancing self-efficacy,forming self-management behaviors,and improving quality of life.