Application of discharge preparation plan based on behavior change wheel theory in ischemic stroke patients with coexisting diseases

TAO Qiuhong; GAO Wenfang; ZHOU Lianfa; SHI Qi

PDF(1653 KB)

Journal of Hunan Normal University(Medical Science) ›› 2025, Vol. 22 ›› Issue (3) : 156-161.

Application of discharge preparation plan based on behavior change wheel theory in ischemic stroke patients with coexisting diseases

TAO Qiuhong¹, GAO Wenfang¹, ZHOU Lianfa¹, SHI Qi²

Author information +

History +

Abstract

Objective To use behaviour change wheel theory (BCW) as the theoretical basis to explore the effect of discharge preparation plan constructed from three aspects: ability, motivation and opportunity in patients with ischemic stroke and multi-morbidity. Methods Sixty cases of ischemic stroke multimorbidity patients admitted to the neurosurgery department of a hospital in Anhui Province from December 2022 to November 2023 were selected as the study subjects and were randomly divided into a control group and an observation group, with 30 cases in each group; the control group implemented the hospital routine nursing care, and the observation group implemented the discharge readiness program based on the BCW theory. Differences in discharge readiness, medication adherence, and quality of life between the two groups were compared at the time of admission, 2 weeks after discharge, and 4 weeks after discharge. Results The scores of all dimensions of discharge preparation in the observation group were higher than those of the control group at the time of discharge. Compared with the time of admission, the scores of medication adherence after discharge were significantly higher in the observation group, and the scores of the observation group were higher than those of the control group. The scores of all dimensions of quality of life in the observation group were higher than those of the control group after 4 weeks of discharge. Conclusion A discharge readiness program based on the BCW theory improves patients' readiness for discharge, medication adherence, and quality of life, and helps to facilitate the long-term rehabilitation management of this patient population.

Key words

behavior change wheel theory / ischemic stroke / multimorbidity / discharge preparation plan / medication compliance / quality of life

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

TAO Qiuhong, GAO Wenfang, ZHOU Lianfa, SHI Qi. Application of discharge preparation plan based on behavior change wheel theory in ischemic stroke patients with coexisting diseases[J]. Journal of Hunan Normal University(Medical Science). 2025, 22(3): 156-161

References

[1] MARKLE-REID M, VALAITIS R, BARTHOLOMEW A, et al. An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: a feasibility study[J]. J Comorb, 2020, 10: 2235042X19900451.
[2] LINDSAY MP, NORRVING B, SACCO RL, et al.World Stroke Organization (WSO): Global Stroke Fact Sheet 2019[J]. Int J Stroke, 2019; 14(8): 806-817.
[3] ABDI S, SPANN A, BORILOVIC J, et al.Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disability and health framework (ICF)[J]. BMC Geriatr, 2019, 19(1): 195.
[4] WORLD HEALTH ORGANIZATION.Multimorbidity[M]. Geneva: The World Health, 2016.
[5] 常峰, 张冉, 等. 共病概念体系研究分析与设计[J], 中国全科医学, 2018, 21(3): 257-260.
[6] ZHANG A, FENG X.Discharge teaching, readiness for hospital discharge and post-discharge outcomes in cataract patients: A structural equation model analysis[J]. J Nurs Manag, 2021, 29(3): 543-552.
[7] 中共中央国务院印发《“健康中国2030”规划纲要》对加强重大传染病防控, 保障食品药品安全和完善公共安全体系提出明确要求[J]. 中国应急管理, 2016(10): 22-24.
[8] 孙超, 奚桓, 李峥, 等. 老年患者出院准备服务专家共识 (2019 版)[J]. 中华护理杂志, 2020, 55(2): 220-227.
[9] 于朋朋, 王艳梅, 朱蕊, 等. 缺血性脑卒中多病共存患者出院准备度现状及其影响因素研究[J]. 中华护理教育, 2023, 20(5): 575-579.
[10] 刘静, 王瑞, 叶丽萍. 脑卒中患者出院准备计划需求度现状调查及影响因素分析[J]. 中西医结合护理 (中英文), 2023, 9(1): 136-138.
[11] JIANG XQ, MORGENSTERN LB, CIGOLLE CT, et al.Multiple chronic conditions and functional outcome after ischemic stroke: a systematic review and meta-analysis[J]. Neuroepidemiology, 2020, 54(3): 205-213.
[12] MICHIE S, VAN STRALEN MM, WEST R.The behaviour change wheel: a new method for characterising and designing behaviour change interventions[J]. Implement Sci, 2011, 6: 42.
[13] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性卒中诊治指南2023[J]. 中华神经科杂志, 2024, 57(6): 523-559.
[14] 武美茹, 邓永梅, 陈义彤, 等. 基于时机理论的出院计划在脑卒中患者出院准备度中的应用研究[J]. 心脑血管病防治, 2023, 23(4): 43-46.
[15] WEISS M E, PIACENTINE L B.Psychometric Properties of the Readiness for Hospital Discharge Scale[J]. J Nurs Meas, 2006, 14(3): 163-180.
[16] LIN Y H, KAO C C, HUANG A M, et al.[Psychometric testing of the Chinese Version of the Readiness for Hospital Discharge Scale] [J]. Hu Li Za Zhi, 2014, 61(4): 56-65.
[17] 陈强, 曲珊珊, 黄欣. 中文版MMAS-8评价心血管慢病患者用药依从性的信效度分析与实践[J]. 中国药房, 2019, 30(2): 268-271.
[18] 李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试[J]. 中华预防医学杂志, 2002, (2): 38-42.
[19] 于朋朋. 缺血性脑卒中多病共存患者出院准备度现状及其影响因素的混合方法研究[D]. 沈阳: 中国医科大学, 2021.
[20] STANTON-FAY S H, HAMILTON K, CHADWICK P M, et al. The DAFNE plus programme for sustained type 1 diabetes self management: intervention development using the behaviour change wheel[J]. Diabet Med, 2021, 38(5): e14548.
[21] BHANDARI B, NARASIMHAN P, VAIDYA A, et al.Barriers and facilitators for treatment and control of high blood pressure among hypertensive patients in Kathmandu, Nepal: a qualitative study informed by COM-B model of behavior change[J]. BMC Public Health, 2021, 21(1): 1524.
[22] 王萍, 高兵兵, 胡燕莹. 基于行为转变理论的健康教育在脑积水脑室腹腔分流术病人中的应用[J]. 护理研究, 2023, 37(13): 2445-2450.
[23] 王小凤, 朱宗红, 张洪霞. 缺血性脑卒中病人出院准备度与出院指导质量的相关性[J]. 护理研究, 2020, 34(3): 511-513.
[24] Agency for Healthcare Research and Quality. Guide to patient and family engagement in hospital quality and safety[EB/OL]. (2023-03-01)[2024-01-10]. https://www.ahrq.gov/patient-safety/patients-families/engagingfamilies/index.html.
[25] 陈维尔, 邱艳, 潘晓华, 等. 我国共病患者服药依从性的研究进展[J]. 中华全科医学, 2023, 21(10): 1745-1748.
[26] 潘婉玉, 张春慧, 张振香, 等. 住院中老年慢性共病病人药物自我管理水平及影响因素分析[J]. 护理研究, 2022, 36(19): 3534-3539.
[27] 龙鑫伶. 基于BCW理论的护理干预在缺血性脑卒中患者健康行为中的应用研究[D]. 昆明: 云南中医药大学, 2023.
[28] 曹琳, 杨振华, 肖卫忠. 多病共存慢性病个性化健康教育模式的探讨[J]. 中华全科医学, 2023, 21(6): 916-919.
[29] 胡方舟, 赵瑞芳, 白杨, 等. 多病共存患者自我效能对生活质量的影响: 坚毅品质的中介作用[J]. 解放军护理杂志, 2022, 39(5): 18-21.
[30] 裴东超, 傅国惠, 尹玥, 等. 保护动机理论的健康教育对脑梗死患者自我效能、心理状态及生活质量的影响[J]. 中国健康心理学杂志, 2021, 29(11): 1636-1641.