基于跨理论模型的运动饮食行为干预在减重手术患者中的应用研究

doi:10.3761/j.issn.0254-1769.2024.18.003

摘要/Abstract

摘要：

目的评价基于跨理论模型的运动饮食行为干预在减重手术患者中的应用效果。方法采用便利抽样法，选取2021年2月—2022年10月在河南省新乡市某三级甲等综合医院普通外科住院治疗的72例减重手术患者作为研究对象，采用随机数字表法，将其分为试验组和对照组，每组各36例。试验组采取基于跨理论模型的运动饮食行为干预，对照组采取常规干预，干预从入院后第1天开始截止至术后6个月。比较两组术前、术后3个月、术后6个月的体重指数、体脂、全身瘦体组织、舒张压、收缩压、空腹血糖、胰岛素抵抗指数（insulin resistance index，HOMA-IR）、健康促进生活方式量表-Ⅱ（Health Promoting Lifestyle Profile-Ⅱ，HPLP-Ⅱ）得分、简明健康状况量表（Short-Form-36 Health Survey，SF-36）得分及术后6周内并发症发生率。结果重复测量方差分析结果显示，两组的人体测量、血压、血糖、HPLP-Ⅱ得分、SF-36得分等指标存在组间交互作用，差异均有统计学意义（P<0.001），其中术后6个月试验组体重指数（23.32±2.32）、体脂（24.10±3.46） kg、全身瘦体组织（41.64±3.24） kg均低于对照组的（27.32±3.64）、（28.46±4.18） kg、（46.68±4.65） kg，差异均具有统计学意义（P<0.001）；术后3、6个月试验组的舒张压、收缩压、空腹血糖、HOMA-IR低于对照组，差异均具有统计学意义（P<0.05）；术后3、6个月试验组的HPLP-Ⅱ各维度得分高于对照组（P<0.001）；术后3、6个月试验组的SF-36得分高于对照组，差异有统计学意义（P<0.001）；试验组并发症发生率为2.56%，与对照组的19.44%相比，差异无统计学意义（P>0.05）。结论基于跨理论模型的运动饮食行为干预可促进减重手术患者健康行为的形成，维持减重效果，改善血压及血糖水平，提升患者的生活质量。

关键词: 减重手术, 并发症, 运动饮食行为, 生活质量, 护理

Abstract:

Objective To evaluate the effect of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery. Methods By convenience sampling，72 patients undergoing weight loss surgery in a tertiary general hospital in Xinxiang City，Henan Province from February 2021 to October 2022 were selected as the research subjects. By a random number table method，they were divided into a test group and a control group，with 36 cases in each group. The test group received exercise-diet behavior intervention based on the trans-theoretical model，while the control group received conventional intervention. The intervention began on the first day after admission and ended 6 months after surgery. The body mass index，body fat，lean body mass，diastolic blood pressure，systolic blood pressure，fasting blood glucose，insulin resistance index（HOMA-IR），Health Promoting Lifestyle Profile-Ⅱ（HPLP-Ⅱ） score，and Short-Form-36 Health Survey（SF-36） score were compared between the 2 groups before and after surgery for 3 and 6 months，as well as the complications within 6 weeks after surgery. Results The results of repeated measures analysis of variance showed that there was an interaction between the 2 groups in terms of anthropometric measurements，blood pressure and blood glucose，HPLP-Ⅱ scores，and SF-36 scores，with statistically significant differences（P<0.001）. After 6 months of surgery，the body mass index （23.32±2.32），body fat（24.10±3.46） kg，and lean body mass（41.64±3.24） kg in the test group were lower than （27.32±3.64），（28.46±4.18） kg，and（46.68±4.65） kg in the control group，and the differences were statistically significant（P<0.001）. At 3 and 6 months after operation，the diastolic blood pressure，systolic blood pressure，fasting blood glucose and HOMA-IR of the test group were lower than those of the control group，and the differences were statistically significant（P<0.05）. The HPLP-Ⅱ score of the test group was higher than that of the control group at 3 and 6 months after operation（P<0.001）. The SF-36 score of the test group was significantly higher than that of the control group at 6 months after operation（P<0.05）. The incidence of complications in the test group was 2.56%，which was not significantly different from 19.44% in the control group （P>0.05）. Conclusion The exercise-dietary behavior intervention based on the transtheoretical model can promote the formation of healthy behaviors in patients undergoing weight loss surgery，maintain weight loss effects，improve blood pressure and blood glucose levels，and enhance the quality of life of patients.

Key words: Weight Loss Surgery, Complications, Exercise and Dietary Behavior, Quality of Life, Nursing Care

吕银雪, 方晓霞, 韩玲, 郭梅娟, 王玲玲, 李进瑾, 范友杰. 基于跨理论模型的运动饮食行为干预在减重手术患者中的应用研究[J]. 中华护理杂志, 2024, 59(18): 2197-2205.

LÜ Yinxue, FANG Xiaoxia, HAN Ling, GUO Meijuan, WANG Lingling, LI Jinjin, FAN Youjie. Application of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery[J]. Chinese Journal of Nursing, 2024, 59(18): 2197-2205.

图/表 5

表1 基于跨理论模型的运动饮食行为干预方案

Table 1 Exercise-diet behavior intervention based on the transtheoretical model

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general information between 2 groups[case（percentage，%）]

表3 两组人体测量指标、血压、糖代谢指标的比较（$\bar{x} \pm s$）

Table 3 Comparison of anthropometric indicators，blood pressure and glucose metabolism indicators between 2 groups（$\bar{x} \pm s$）

表4 两组健康生活方式得分的比较（分，$\bar{x} \pm s$）

Table 4 Comparison of healthy lifestyle scores between 2 groups（scores，$\bar{x} \pm s$）

表5 两组生活质量得分的比较（分，$\bar{x} \pm s$）

Table 5 Comparison of quality of life between 2 groups（scores，$\bar{x} \pm s$）

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