Abstract:

Objective To explore the stage characteristics of cognitive promotion behaviors and preferences for digital interventions among community-dwelling older adults with subjective cognitive decline（SCD），and to provide a reference for implementing precise nursing interventions in clinical practice. Methods Using purposive sampling，semi-structured interviews were conducted with 52 community-dwelling older adults with SCD in Suzhou City from March to May 2025，based on the Health Action Process Approach（HAPA） model. Data were analyzed using deductive thematic analysis. Results A total of 2 main themes and 8 sub-themes were identified. ①Stage Positioning and core characteristics of cognitive promotion actions in older adults with SCD（the pre-intention stage is a dual obstacle of cognitive bias and lack of willingness；the intention stage is a lack of adaptation between cognitive awakening and action threshold；the action stage is a preliminary synergy between cognitive clarity and regular execution；the maintenance stage is a deep integration of value internalization and action resilience）. ②Preferences and Concerns Regarding Digital Interventions（preferences for light-weight science education and case guidance in the pre-intention stage，with concerns about technological usability and content authenticity；preferences for minimalist interaction and social incentives in the intention stage，with concerns about insufficient ability；preferences for obstacle response and behavior reinforcement in the action stage，with concerns about technological stability；preferences for advanced interaction and experience sharing in the maintenance stage，with concerns about privacy and security）. Conclusion A dynamically adaptive digital intervention pathway should be constructed based on the behavioral stage characteristics of older adults with SCD. Differentiated strategies should be designed to address the core barriers and preference demands at each stage，thereby enhancing the precision and sustainability of cognitive promotion behavior interventions.

Key words: Subjective Cognitive Decline, Health Action Process Approach Model, Cognitive Promotion Behavior, Digital Intervention, Qualitative Research, Geriatric Nursing

摘要：

目的 探索社区主观认知下降老年患者认知促进行为的阶段特征及数字化干预偏好，为临床开展精准护理干预提供参考。 方法 采用目的抽样法，于2025年3—5月，基于健康行动过程取向模型，对苏州市52例社区主观认知下降老年患者进行半结构式访谈，运用演绎式主题分析法进行资料分析。 结果 提炼出2个主题和8个亚主题。①主观认知下降老年人认知促进行为阶段定位与核心特征：前意向阶段为认知偏差与意愿缺失的双重阻碍；意向阶段为认知觉醒与行动门槛的适配不足；行动阶段为认知清晰与规律执行的初步协同；维持阶段为价值内化与行动韧性的深度融合。②数字化干预的需求偏好与顾虑：前意向阶段偏好轻量科普与案例引导，顾虑技术易用性和真实性；意向阶段偏好极简交互和社交激励，顾虑能力不足；行动阶段偏好障碍应对与行为强化，顾虑技术稳定性；维持阶段偏好进阶互动与经验分享，顾虑隐私安全。 结论 应基于社区主观认知下降老年人行为阶段特征构建动态适配的数字化干预路径，针对不同阶段的核心障碍与需求偏好设计差异化策略，以提升认知促进行为干预的精准性与可持续性。

关键词: 主观认知下降, 健康行动过程取向模型, 认知促进行为, 数字化干预, 质性研究, 老年人护理