Abstract:

Objective To develop a perioperative proactive health behavior intervention program for colorectal cancer patients undergoing ostomy surgery and verify its preliminary application effects.Methods The program was formulated through literature review，qualitative interviews，and Delphi expert consultations. The intervention program comprised 3 first-level，9 second-level，and 27 third-level indicators. Patients hospitalized for colorectal cancer undergoing ostomy surgery at a tertiary hospital in Anhui Province between January and November 2025 were recruited as study participants. Using the drawing lots method，patients were randomized by ward into groups：33 patients from Ward A were assigned to an experimental group，and 33 from Ward B to a control group. The control group received routine care，while the experimental group received the intervention program in addition to routine care. The application effects were then evaluated.Results A total of 32 cases in the experimental group and 31 cases in the control group completed the study. Preliminary application results showed a significant difference in ostomy complication rates between the 2 groups at 1 and 3 months post-intervention（P<0.05），and the incidence in the experimental group was lower than that in the control group. Repeated measures ANOVA showed that there was a time and group interaction effect on self-management ability，self-efficacy，health promoting behavior level，and quality of life between the 2 groups of patients（P<0.05）. Simple effects analysis showed that at 1 and 3 months after intervention，the experimental group had significantly higher scores in self-management ability，self-efficacy，health promoting behavior level，and quality of life than the control group（P<0.001）.Conclusion The implementation of this program can effectively enhance self-management ability，self-efficacy，and health-promoting behavior levels in colorectal cancer patients undergoing ostomy surgery，thereby improving their quality of life.

Key words: Colorectal Neoplasms, Health Action Process Approach Model, Proactive Health Behavior, Perioperative Nursing

摘要：

目的 构建结直肠癌造口患者围手术期主动健康行为干预方案，并验证其应用效果。方法 通过文献研究、半结构式访谈及专家函询形成方案。干预方案包括3个一级指标、9个二级指标和27个三级指标。选取2025年1—11月在安徽省某三级甲等医院住院治疗的结直肠癌造口患者作为研究对象。采用抽签法，以病区为单位随机分组，将A病区33例纳入试验组，B病区33例纳入对照组。试验组在常规护理的基础上施行该方案，对照组予以常规护理，并评价其应用效果。结果 最终试验组32例、对照组31例完成研究。研究结果显示，两组干预后1、3个月造口并发症发生率比较，差异具有统计学意义（均P<0.05），且试验组的发生率低于对照组。重复测量方差分析显示，两组的自我管理能力、自我效能感、健康促进行为水平和生活质量均存在时间与组间的交互效应（均P<0.05）。简单效应分析显示，干预后1、3个月，试验组的自我管理能力、自我效能感、健康促进行为水平和生活质量得分均高于对照组，差异具有统计学意义（P<0.001）。结论 该方案的实施可有效提升结直肠癌造口患者的自我管理能力、自我效能感及健康行为水平，进而改善患者的生活质量。

关键词: 结直肠肿瘤, 健康行动过程取向模型, 主动健康行为, 围手术期护理