Abstract:

Objective To construct an intervention protocol for preventing osteoporotic re-fractures in older patients and to evaluate its feasibility，thereby providing a reference for the clinical practice in re-fracture prevention. Methods Guided by Social Cognitive Theory and the Health Belief Model，a preliminary protocol was developed based on literature review and qualitative interviews. The scientific validity and feasibility of the program were assessed through expert meetings to develop the final version. Using convenience sampling，8 older patients with osteoporotic fractures from the orthopedics department of a tertiary hospital in Beijing were enrolled from June to August 2025. Participant feedback，participation rate，acceptance，and implementation quality were used to evaluate the feasibility. Results A total of 9 experts participated in 2 rounds of expert panel discussions. The expert authority coefficient was 0.901. The final protocol consisted of 3 intervention phases（Level Ⅰ indicators），9 intervention strategies （Level Ⅱ indicators），and 30 intervention measures（Level Ⅲ indicators）. During the 6-week intervention period，no patient dropouts or adverse events such as falls/fractures occurred. The scores for intervention quality evaluation were all above 4 points；regarding intervener acceptance，all item scores except for scheduling were above 4 points；in patient acceptance evaluation，scores for interest and level of identification were above 4 points，but the score for flexibility of intervention focus was relatively low. Conclusion The intervention program for preventing osteoporotic re-fractures in older patients demonstrates scientific validity. Feasibility evaluation suggests a lack of perceived personalization. Future research should focus on developing patient characteristic clustering models to achieve precise matching and personalization of intervention programs，thereby enhancing prevention effectiveness and resource utilization efficiency.

Key words: Osteoporotic Fractures, Re-Fracture, Aged, Nursing Care

摘要：

目的 构建老年患者骨质疏松性再骨折预防方案并进行可行性评价，为开展再骨折预防临床实践提供参考。方法 以社会认知理论和健康信念模式为理论指导，在文献研究、质性研究的基础上，初步拟订老年患者骨质疏松性再骨折预防方案。通过专家会议对方案的科学性和可行性进行论证，经修订后形成终稿。采用便利抽样法，选取2025年6—8月北京市某三级甲等医院骨科收治的老年骨质疏松性骨折患者8例，通过参与者反馈、参与度、接受度、实施质量评价方案的可行性。结果 共9名专家参与2轮专家论证会，权威系数为0.901。最终构建的方案包括3项一级指标、9项二级指标和30项三级指标。干预期间无患者脱落，未发生跌倒、骨折等不良事件。干预质量评价得分均高于4分；干预者接受度得分除时间安排以外，其他条目均高于4分；患者接受度评价中兴趣和认同程度得分均高于4分，但干预重点灵活度得分较低。结论 该研究构建的老年患者骨质疏松性再骨折预防方案具有科学性，可行性评价提示患者感知干预个性化较为欠缺。

关键词: 骨质疏松性骨折, 再骨折, 老年人, 护理