Abstract:

Objective To develop and apply a rehabilitation nursing protocol for diabetic lower extremity arteriosclerotic obliterans（DLASO） patients post-intervention，and to provide a practical basis for clinical practice. Methods Based on the Health Action Process Approach（HAPA） model，an intervention protocol was developed through literature review，expert consultation，and a pilot study. A total of 154 DLASO patients receiving interventional therapy between January and June 2025 in vascular surgery departments of 2 campuses of a tertiary hospital in Nanchang were selected by convenience sampling and assigned by ward unit. Groups were determined by coin toss，with 77 patients each in an experimental group（HAPA-based rehabilitation） and a control group （routine care）. The differences in lower limb blood flow，motor function，self-management ability，blood glucose control，and complication rates were compared between the 2 groups. Results The final protocol included 3 primary items，8 secondary items，and 19 tertiary items. At the 3-month follow-up，the intervention group（74 cases） demonstrated superior outcomes in lower limb perfusion，motor function，glycemic control，and self-management（P<0.05） than the control group（72 cases），with significant time，group and interaction effects（P<0.001）. The incidence of postoperative complications in the experimental group was 6.76%，which was lower than 18.06% in the control group. A comparison between the 2 groups showed that the difference was statistically significant（P=0.038）. Conclusion The HAPA-based rehabilitation care protocol for DLASO patients is both scientific and practical. It significantly improves lower limb perfusion，motor function，self-management，and glycemic control，and thereby reducs the incidence of postoperative complications.

Key words: Lower Limb Arteriosclerosis Obliterans, Diabetes Mellitus, Health Action Process Approach Model, Rehabilitation Care

摘要：

目的 构建糖尿病下肢动脉硬化闭塞症（diabetic lower limb arteriosclerotic obliterans，DLASO）患者介入术后康复护理方案并进行临床应用，为开展DLASO患者介入术后康复护理提供依据。方法 基于健康行为过程取向（health action process approach，HAPA）模型，通过文献分析、专家函询及预试验构建干预方案。采用便利抽样法，选取2025年1—6月在南昌市某三级甲等医院血管外科行介入治疗的154例DLASO患者为研究对象，以病区为单位进行分组，通过抛硬币法确定试验组与对照组，每组各77例，试验组采用基于HAPA模型的介入术后康复护理方案，对照组给予常规护理。比较两组干预前后下肢血运、运动功能、自我管理能力、血糖相关指标及术后并发症发生率的差异。结果 最终构建的方案包含3个一级条目、8个二级条目和19个三级条目。试验组74例、对照组72例完成该研究。干预3个月后，试验组下肢血运、运动功能、血糖相关指标及自我管理能力均优于对照组（均P<0.05），不同时间点两组比较，存在时间、组间及交互效应（均P<0.001）；试验组术后并发症发生率为6.76%，低于对照组的18.06%，两组比较，差异具有统计学意义（P=0.038）。结论 基于HAPA模型的DLASO患者介入术后康复护理方案具有科学性和可行性，能有效增强患者下肢血运和运动功能，提升其自我管理能力，改善血糖水平，从而降低术后并发症的发生率。

关键词: 下肢动脉硬化闭塞, 糖尿病, 健康行为过程取向模型, 康复护理