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Article(id=1241102740881985759, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202309285, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1694620800000, receivedDateStr=2023-09-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831552000, onlineDateStr=2026-03-18, pubDate=1721836800000, pubDateStr=2024-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831552000, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831552000, creator=13701087609, updateTime=1773831552000, updator=13701087609, issue=Issue{id=1241102730337505325, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831549486, creator=13701087609, updateTime=1773831697291, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103350322745680, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103350322745681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2615, endPage=2619, ext={EN=ArticleExt(id=1241102741389496571, articleId=1241102740881985759, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Impact of intervention based on planned behavior theory on disease cognition, exercise self-efficacy, and daily living ability in elderly patients with sarcopenia, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effects of intervention based on planned behavior theory on disease cognition, exercise self-efficacy, and daily living ability in elderly patients with sarcopenia.

Methods

Using convenience sampling method, 124 elderly patients with sarcopenia were selected from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City as the research subjects. Using the coin toss method, 62 elderly people from Lishuiwan community were included in the intervention group on a residential community basis, while 62 elderly people from Shuxiangyuan community were included in the control group. The intervention group implemented interventions based on the Theory of Planned Behavior, which included five aspects: behavioral attitude, support from important others, perceived behavioral control, behavioral intention, and behavior. The control group maintained their original lifestyle and the intervention duration was 12 weeks. Two groups of patients were evaluated using the Simplified Disease Cognitive Questionnaire, Exercise Self Efficacy Scale, and Daily Living Ability Scale before and 12 weeks after intervention.

Results

Before intervention, there was no statistically significant difference in disease cognition, exercise self-efficacy, and daily living ability scores between the two groups of patients (P>0.05). After intervention, the elderly patients in the intervention group showed improvements in disease cognition, exercise self-efficacy, and daily living ability compared to the control group, with statistically significant differences (P<0.05).

Conclusion

Interventions based on planned behavior theory can improve the disease cognition level, exercise self-efficacy, and daily living ability of elderly patients with sarcopenia.

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目的

探讨基于计划行为理论的干预对老年肌少症患者疾病认知、运动自我效能以及日常生活能力的影响。

方法

采用便利抽样法，选取石家庄市丽水湾社区和书香苑社区的124例老年肌少症患者为研究对象。使用抛硬币法以居住社区为单位将丽水湾社区的62例老年人纳入干预组，书香苑社区的62例老年人纳入对照组。干预组实施基于计划行为理论的干预，包含行为态度、重要他人支持、知觉行为控制、行为意向以及行为五个方面；对照组维持原来的生活方式，干预时长为12周。分别在干预前、12周后采用简易疾病认知问卷、运动自我效能量表和日常生活能力量表对两组患者进行效果评价。

结果

干预前，两组患者的疾病认知、运动自我效能及日常生活能力得分比较均无统计学差异（P>0.05）；干预后，干预组老年患者疾病认知、运动自我效能及日常生活能力与对照组相比均有改善，差异有统计学意义（P<0.05）。

结论

基于计划行为理论的干预能够提高老年肌少症患者的疾病认知水平、运动自我效能，改善日常生活能力。

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邢凤梅，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Q7Q4lh+LCJlfKwrpojc9PQ==, magXml=9AAg7MxV0kove8pqFJh3TA==, pdfUrl=null, pdf=rB8NakP1nEMf2u3+8T3uaw==, pdfFileSize=565650, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=v0MGW2Ocyrmt3cZBdpan9w==, mapNumber=null, authorCompany=null, fund=null, authors=

杨雅楠（1998—），女，硕士在读，研究方向：老年人护理

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杨雅楠（1998—），女，硕士在读，研究方向：老年人护理

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杨雅楠（1998—），女，硕士在读，研究方向：老年人护理

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International Journal of Environmental Research and Public Health, 2021, 18(13): 6762., articleTitle=Effects of 16 weeks of resistance training on muscle quality and muscle growth factors in older adult women with sarcopenia: a randomized controlled trial, refAbstract=null), Reference(id=1241102758435147846, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, doi=null, pmid=null, pmcid=null, year=2022, volume=49, issue=22, pageStart=4163, pageEnd=4168, url=null, language=null, rfNumber=[20], rfOrder=29, authorNames=于甜栖, 孙国珍, 高敏, journalName=现代预防医学, refType=null, unstructuredReference=于甜栖，孙国珍，高敏，等．运动自我效能在慢性心力衰竭患者运动恐惧与运动康复依从性间的中介效应[J]．现代预防医学，2022，49（22）：4163-4168., articleTitle=运动自我效能在慢性心力衰竭患者运动恐惧与运动康复依从性间的中介效应, refAbstract=null), Reference(id=1241102758514839624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, doi=null, pmid=null, pmcid=null, year=2022, volume=49, issue=22, pageStart=4163, pageEnd=4168, url=null, language=null, rfNumber=[20], rfOrder=30, authorNames=Yu TQ, Sun GZ, Gao M, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Yu TQ, Sun GZ, Gao M, et al. Mediation effect of self-efficacy for exercise on the relationship between kinesiophobia and exercise rehabilitation adherence in patients with heart failure[J]. Modern Preventive Medicine, 2022, 49(22): 4163-4168., articleTitle=Mediation effect of self-efficacy for exercise on the relationship between kinesiophobia and exercise rehabilitation adherence in patients with heart failure, refAbstract=null)], funds=[Fund(id=1241102754375062478, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, awardId=ZF2023004, language=CN, fundingSource=2023年政府资助临床医学优秀人才培养项目(ZF2023004), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241102747592872538, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, xref=1., ext=[AuthorCompanyExt(id=1241102747601261147, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, companyId=1241102747592872538, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Nursing and Rehabiliation, North China University of Science and Technology, Tangshan, Hebei 063200, China), AuthorCompanyExt(id=1241102747609649757, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, companyId=1241102747592872538, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.华北理工大学护理与康复学院， 河北 唐山 063200)]), AuthorCompany(id=1241102748247183975, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, xref=2., ext=[AuthorCompanyExt(id=1241102748251378280, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, companyId=1241102748247183975, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.华北理工大学临床医学院)]), AuthorCompany(id=1241102748368818802, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, xref=3., ext=[AuthorCompanyExt(id=1241102748377207411, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, companyId=1241102748368818802, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.华北理工大学附属医院)])], figs=[ArticleFig(id=1241102753506841495, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=EN, label=Table 1, caption=

Comparison of Basic Information between Two Groups of Patients

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类别干预组（n=61）n(%)对照组（n=60）n(%)t/χ2值P值
性别0.0080.928
男30(49.2)30（50.0）
女31(50.8)30（50.0）
年龄（岁）74.93±5.7374.25±5.390.6770.500
文化程度()1.5550.460
小学及以下24(39.3)28(46.7)
初中26(42.6)19(31.7)
高中及以上11(18.0)13(21.7)
婚姻状况0.8280.363
有配偶39(63.9)43(71.7)
无配偶22(36.1)17(28.3)
家庭月均收入（元）3.0570.383
<1 00016(26.2)19(31.7)
1 000~2 99927(44.3)21(35.0)
3 000~5 00013(21.3)10(16.7)
>5 0005(8.2)10(16.7)
), ArticleFig(id=1241102753636864927, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=CN, label=表1, caption=

两组患者基本情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
类别干预组（n=61）n(%)对照组（n=60）n(%)t/χ2值P值
性别0.0080.928
男30(49.2)30（50.0）
女31(50.8)30（50.0）
年龄（岁）74.93±5.7374.25±5.390.6770.500
文化程度()1.5550.460
小学及以下24(39.3)28(46.7)
初中26(42.6)19(31.7)
高中及以上11(18.0)13(21.7)
婚姻状况0.8280.363
有配偶39(63.9)43(71.7)
无配偶22(36.1)17(28.3)
家庭月均收入（元）3.0570.383
<1 00016(26.2)19(31.7)
1 000~2 99927(44.3)21(35.0)
3 000~5 00013(21.3)10(16.7)
>5 0005(8.2)10(16.7)
), ArticleFig(id=1241102753766888355, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=EN, label=Table 2, caption=

Comparison of simple disease cognition scores between two groups of patients before and after intervention (, points)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后t值P值
对照组6047.98±6.8348.05±6.62-0.4010.690
干预组6147.28±6.7132.23±6.4737.734<0.001
t值-0.572-13.291
P值0.568<0.001
), ArticleFig(id=1241102753846580138, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=CN, label=表2, caption=

两组患者干预前后简易疾病认知评分比较（，分）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后t值P值
对照组6047.98±6.8348.05±6.62-0.4010.690
干预组6147.28±6.7132.23±6.4737.734<0.001
t值-0.572-13.291
P值0.568<0.001
), ArticleFig(id=1241102753926271920, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=EN, label=Table 3, caption=

Comparison of exercise self-efficacy scores between two groups of patients before and after intervention (, points)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后t值P值
对照组6031.00±9.0830.85±8.761.0540.296
干预组6130.49±8.8365.03±8.80-72.483<0.001
t值-0.31221.417
P值0.756<0.001
), ArticleFig(id=1241102754026935223, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=CN, label=表3, caption=

两组患者干预前后运动自我效能评分比较（，分）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后t值P值
对照组6031.00±9.0830.85±8.761.0540.296
干预组6130.49±8.8365.03±8.80-72.483<0.001
t值-0.31221.417
P值0.756<0.001
), ArticleFig(id=1241102754119209916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=EN, label=Table 4, caption=

Comparison of daily living ability scores between two groups of patients before and after intervention (, points)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后
躯体生活自理能力工具性日常生活能力总分躯体生活自理能力工具性日常生活能力总分
对照组607.92±1.2018.38±3.7726.30±4.738.02±1.26a18.97±4.11a26.98±5.17a
干预组618.07±1.1119.00±3.5527.07±4.387.57±0.99a16.92±3.31a24.49±4.07a
t值0.7100.9270.924-2.156-3.020-2.950
P值0.4790.3560.3570.0330.0030.004
), ArticleFig(id=1241102754232456131, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102740881985759, language=CN, label=表4, caption=

两组患者干预前后日常生活能力评分比较（，分）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别n干预前干预后
躯体生活自理能力工具性日常生活能力总分躯体生活自理能力工具性日常生活能力总分
对照组607.92±1.2018.38±3.7726.30±4.738.02±1.26a18.97±4.11a26.98±5.17a
干预组618.07±1.1119.00±3.5527.07±4.387.57±0.99a16.92±3.31a24.49±4.07a
t值0.7100.9270.924-2.156-3.020-2.950
P值0.4790.3560.3570.0330.0030.004
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基于计划行为理论的干预对老年肌少症患者疾病认知、运动自我效能及日常生活能力的影响
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杨雅楠 1 , 于瑶 1 , 邢凤梅 2 , 蔡逢雨 3 , 薛新宏 3 , 王晓光 3 , 张小丽 1
现代预防医学 | 健康与社会行为 2024,51(14): 2615-2619
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现代预防医学 | 健康与社会行为 2024, 51(14): 2615-2619
基于计划行为理论的干预对老年肌少症患者疾病认知、运动自我效能及日常生活能力的影响
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杨雅楠1, 于瑶1, 邢凤梅2 , 蔡逢雨3, 薛新宏3, 王晓光3, 张小丽1
作者信息
  • 1.华北理工大学护理与康复学院， 河北 唐山 063200
  • 2.华北理工大学临床医学院
  • 3.华北理工大学附属医院

    • 杨雅楠（1998—），女，硕士在读，研究方向：老年人护理

通讯作者:

邢凤梅，E-mail：
Impact of intervention based on planned behavior theory on disease cognition, exercise self-efficacy, and daily living ability in elderly patients with sarcopenia
Ya-nan YANG1, Yao YU1, Feng-mei XING2 , Feng-yu CAI3, Xin-hong XUE3, Xiao-guang WANG3, Xiao-li ZHANG1
Affiliations
  • School of Nursing and Rehabiliation, North China University of Science and Technology, Tangshan, Hebei 063200, China
出版时间: 2024-07-25 doi: 10.20043/j.cnki.MPM.202309285
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摘要
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目的

探讨基于计划行为理论的干预对老年肌少症患者疾病认知、运动自我效能以及日常生活能力的影响。

方法

采用便利抽样法，选取石家庄市丽水湾社区和书香苑社区的124例老年肌少症患者为研究对象。使用抛硬币法以居住社区为单位将丽水湾社区的62例老年人纳入干预组，书香苑社区的62例老年人纳入对照组。干预组实施基于计划行为理论的干预，包含行为态度、重要他人支持、知觉行为控制、行为意向以及行为五个方面；对照组维持原来的生活方式，干预时长为12周。分别在干预前、12周后采用简易疾病认知问卷、运动自我效能量表和日常生活能力量表对两组患者进行效果评价。

结果

干预前，两组患者的疾病认知、运动自我效能及日常生活能力得分比较均无统计学差异（P>0.05）；干预后，干预组老年患者疾病认知、运动自我效能及日常生活能力与对照组相比均有改善，差异有统计学意义（P<0.05）。

结论

基于计划行为理论的干预能够提高老年肌少症患者的疾病认知水平、运动自我效能，改善日常生活能力。

肌少症  /  老年患者  /  计划行为理论  /  干预
Objective

To explore the effects of intervention based on planned behavior theory on disease cognition, exercise self-efficacy, and daily living ability in elderly patients with sarcopenia.

Methods

Using convenience sampling method, 124 elderly patients with sarcopenia were selected from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City as the research subjects. Using the coin toss method, 62 elderly people from Lishuiwan community were included in the intervention group on a residential community basis, while 62 elderly people from Shuxiangyuan community were included in the control group. The intervention group implemented interventions based on the Theory of Planned Behavior, which included five aspects: behavioral attitude, support from important others, perceived behavioral control, behavioral intention, and behavior. The control group maintained their original lifestyle and the intervention duration was 12 weeks. Two groups of patients were evaluated using the Simplified Disease Cognitive Questionnaire, Exercise Self Efficacy Scale, and Daily Living Ability Scale before and 12 weeks after intervention.

Results

Before intervention, there was no statistically significant difference in disease cognition, exercise self-efficacy, and daily living ability scores between the two groups of patients (P>0.05). After intervention, the elderly patients in the intervention group showed improvements in disease cognition, exercise self-efficacy, and daily living ability compared to the control group, with statistically significant differences (P<0.05).

Conclusion

Interventions based on planned behavior theory can improve the disease cognition level, exercise self-efficacy, and daily living ability of elderly patients with sarcopenia.

Sarcopenia  /  Elderly patients  /  Theory of planned behavior  /  Intervention
杨雅楠, 于瑶, 邢凤梅, 蔡逢雨, 薛新宏, 王晓光, 张小丽. 基于计划行为理论的干预对老年肌少症患者疾病认知、运动自我效能及日常生活能力的影响. 现代预防医学, 2024 , 51 (14) : 2615 -2619 . DOI: 10.20043/j.cnki.MPM.202309285
Ya-nan YANG, Yao YU, Feng-mei XING, Feng-yu CAI, Xin-hong XUE, Xiao-guang WANG, Xiao-li ZHANG. Impact of intervention based on planned behavior theory on disease cognition, exercise self-efficacy, and daily living ability in elderly patients with sarcopenia[J]. Modern Preventive Medicine, 2024 , 51 (14) : 2615 -2619 . DOI: 10.20043/j.cnki.MPM.202309285
正文
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肌少症是一种与年龄相关，以骨骼肌力量下降、肌量减少和身体功能下降为主要特征的老年综合征，其在社区老年群体中患病率高达11%[1]，是失能等不良健康结局的重要预测因子[2]。运动干预是治疗肌少症的一种有效手段[3]。但现有证据显示，肌少症老年人运动锻炼的治疗效果存在异质性，多数患者在接受运动干预后身体状况并未产生有利变化，被称为运动不响应患者[4]，可能与老年人运动训练的持续性不佳有关。目前多数研究聚焦运动干预方式的疗效差异[5]，鲜有研究关注患者自身的运动响应。计划行为理论[6]认为，个体的行为受其行为意向支配，而行为意向由行为态度、重要他人支持及知觉行为控制共同决定，通过提高患者的疾病认知程度，可减轻患者对疾病的负性感知，激发其对抗疾病的信心，持续付诸行动以保障治疗效果，为促使患者积极参与自身健康管理提供了新的思路[7]。目前该理论已在健康行为管理中取得了较为满意的效果[8]。本研究据计划行为理论中行为态度、重要他人支持、知觉行为控制、行为意向及行为五个要素设计相应的干预方案，旨在提高老年肌少症患者对运动的应答，改善其日常生活能力，从而有效改善肌少症。
1　对象与方法
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1.1　对象
于2022年9月至2023年2月，采用便利抽样法，选取河北省石家庄市丽水湾社区和书香苑社区招募的124例老年肌少症患者为研究对象。为避免沾染，使用抛硬币法以居住社区为单位将丽水湾社区的62例老年人纳入干预组，书香苑社区的62例老年人纳入对照组。纳入标准：（1）符合中国老年人肌少症诊疗专家共识(2021)中的肌少症诊断标准[9]；（2）年龄≥60岁；（3）在所在社区居住时间≥6个月；（4）意识清楚，可独立回答问题；（5）知情同意。排除标准：（1）存在严重的视、听障碍或沟通困难；（2）存在精神疾病；（3）处于疾病终末期，预期寿命≤6个月；（4）患有心、脑、肾等危重疾病无法配合干预；（5）存在关节疼痛、骨折等运动禁忌症；（6）同时参与其他研究。剔除标准：（1）不能按要求完成12周训练；（2）中途失联；（3）中途退出；（4）中途死亡。干预过程中干预组剔除1例（失访1例），对照组剔除2例（失访2例），最终干预组纳入61例，对照组纳入60例。本研究已获华北理工大学医学伦理委员会审批，伦理审批号为：No.2022225。
1.2　干预措施
对照组：维持原来的生活方式。干预组：实施基于计划行为理论的干预，共干预12周，干预措施包括：（1）行为态度：①利用自行设计的疾病知识手册，对患者实施健康宣教，传授肌少症疾病相关知识。②发放运动图集，带领患者学习运动训练动作，直至患者熟练掌握。（2）行为：患者进行每周3次（两次训练间隔大于48小时），持续12周的运动训练，训练时间每次约70 min。1）运动内容：根据肌少症运动证据总结设计，无危险动作，适合老年人，包括热身运动、弹力带抗阻运动、八段锦有氧运动、平衡训练以及整理运动。2）运动强度：遵循循序渐进原则，1~3周实施低强度训练，4~12周实施中等强度训练，使用谈话[10]测试法来衡量运动强度。3）运动形式：1~3周每周在社区中心广场组织一次集体训练，规范患者训练动作；4~12周为居家训练，患者在家庭成员陪同下完成训练。4）运动原则：①个体化原则：研究者与患者保持联系，根据患者耐力及时调整运动处方；②运动中监测：训练过程中认真观察患者身体状况，如出现头晕、气喘等不适症状，立即嘱患者停止运动。集体训练时由研究者监测，居家训练时由家庭成员监测。（3）重要他人支持：于第2、5、8、11周进行电话随访：①与患者沟通训练情况，鼓励患者坚持训练。②纠正患者的错误运动，解答其所遇问题。③鼓励家庭成员参与健康教育并及时督促患者运动。④教会家庭成员运动监测的具体方式，保障患者运动的安全性。（4）知觉行为控制：组建微信群，每周一在微信群推送肌少症疾病及运动相关知识和成功案例，告知患者和家庭成员运动中的注意事项。（5）行为意向：于第3、6、9、12周进行家庭访视：①询问患者的运动情况，对依从性较好的患者发放奖品，对依从性较差的患者给予鼓励。②鼓励患者或家庭成员在微信群中分享患者的运动视频，参与沟通交流，分享经验。
1.3　调查方法
分别在干预前、干预12周后调查患者的疾病认知水平、运动自我效能及日常生活能力。评价工具包括：①采用简易疾病认知量表（BIPQ）评定疾病认知水平，该量表由Broadbent等人编制，包含8个条目，各条目评分方式均为0~10级评分，条目3、4、7采用反向计分方式，总分0~80分，得分越高表示患者对其所患疾病持有的负性感知越重。该量表的Cronbach α系数为0.79。②采用运动自我效能量表（SEE）评定运动自我效能，该量表由Resnick等人编制，测量患者对自身坚持运动的自信水平，每个条目从没什么信心到非常有信心依次计0~10分，总分0~90分。得分越高表明患者规律运动的自信程度越高。该量表的Cronbach α系数为0.83。③采用Lawton和Brody开发的ADL量表评估日常生活能力，该量表包括身体自理能力和工具性日常生活能力两部分，共14项。各个条目均采用4级评分法，从1~4分分别表示能够完全自主完成、部分独立完成、需要协助完成和根本无法完成，总分范围为14~56分。得分越高患者的日常生活能力越差。该量表的Cronbach α系数为0.84。
1.4　统计处理
采用Excel录入数据。使用SPSS 28.0软件完成统计学分析，符合正态分布的计量资料，用均数±标准差来表示数据的集中程度和离散程度，不同组间比较采用两独立样本t检验，同一组内比较使用配对样本t检验。计数资料用例数、百分比表示，采用χ2检验行组间比较。检验水准α=0.05。
2　结果
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2.1　两组患者的基本情况
对干预组和对照组患者的基本情况包括性别、年龄、文化程度、婚姻状况及家庭月均收入等方面进行比较，差异均无统计学意义（P>0.05）。见表1。
2.2　干预前后两组患者简易疾病认知评分比较
干预前，干预组与对照组患者的简易疾病认知问卷评分差异无统计学意义(P>0.05)；在干预之后，干预组患者评分较对照组低，差异有统计学意义(P<0.05)；干预后干预组患者评分较干预前有所降低 (P<0.05)；对照组患者评分与干预前相比无显著变化(P>0.05)。见表2。
2.3　干预前后两组患者运动自我效能评分比较
在干预之前，两组患者运动自我效能评分差异无统计学意义(P>0.05)；在干预之后，干预组患者运动自我效能评分较对照组高，差异具有统计学意义(P<0.05)；干预后干预组患者运动自我效能评分较干预前明显提高(P<0.05)；对照组无显著变化(P>0.05)。见表3。
2.4　干预前后两组患者日常生活能力评分比较
在干预之前，两组患者在日常生活能力总分、躯体生活自理能力和工具性日常生活能力评分方面无显著差异(P>0.05)；在干预之后，干预组患者的躯体生活自理能力、工具性日常生活能力评分及日常生活活动能力总分均低于对照组，差异具统计学意义(P<0.05)；干预后干预组患者躯体生活自理能力、工具性日常生活能力评分以及日常生活能力总分均较干预前降低（P<0.05）；对照组均较干预前提高（P<0.05）。见表4。
3　讨论
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3.1　基于计划行为理论的干预有利于提高老年肌少症患者对肌少症的认知水平
本研究发现，接受干预的老年肌少症患者相比于干预前，其疾病认知水平明显提高，这与雍桂珍等[11]的研究结果一致。分析原因，本研究在行为态度方面采取了图文并茂的方式向患者提供全面、持续的疾病健康教育。通过深入了解肌少症有关知识，患者可以减轻对疾病的负性感知，提高认知水平。此外，叶敏等[12]的研究结果表明，疾病的认知程度可以预测患者的自我管理行为。患者对所患疾病的了解越多，就越能意识到疾病的可控性，并主动参与到疾病的自我管理中，积极配合治疗。因此，社区护理人员应该重视疾病认知对患者行为执行的影响，及时纠正患者错误的疾病认知，促使其建立积极的行为态度，并主动参与自我健康管理。
3.2　基于计划行为理论的干预可增强老年肌少症患者的运动自我效能
运动自我效能[13]是个体坚持规律运动的信念，直接影响个体的运动行为。本研究结果显示，接受干预的老年肌少症患者的运动自我效能水平显著提高，而对照组则无明显变化，这表明基于计划行为理论的干预能够提高患者的运动自我效能。可能的原因是，以计划行为理论为框架的干预针对患者的特点和需求，向患者传授疾病知识，促使其形成正确的运动观念，激发其改善身体状况的积极性[14]。此外，社会支持对患者的健康行为具有强化作用[15]，通过增加家庭成员和研究者与患者之间的沟通与联系，为其提供积极支持，有助于增强患者进行运动训练的自信心。这提示社区护理人员可以通过增强肌少症患者对运动的理解和意义感，提高其运动自我效能，从而促进运动行为的转化。
3.3　基于计划行为理论的干预能提高老年肌少症患者的日常生活能力
本研究结果表明，接受干预的老年肌少症患者的日常生活能力得到加强，与赵莹楚等[16]的结果一致。这一结果的原因在于，规律的运动可以加快骨骼肌的血液循环，促进机体代谢，同时也可以提高患者的肌肉力量和质量[17-18]，促使患者的身体功能逐步改善[19]。此外，患者疾病认知程度和运动自我效能水平的提高为其运动响应提供了保障[20]，从而促进了运动效果的达标，有助于提高日常生活能力和改善生活质量。
综上，基于计划行为理论的干预可有效提高社区老年肌少症患者的疾病认知、运动自我效能及日常生活能力，可在社区老年肌少症人群中推广应用。另外，本研究干预时间较短，未来将延长干预时间，进一步探究其远期效果。
基金
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  • 2023年政府资助临床医学优秀人才培养项目(ZF2023004)
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2024年第51卷第14期
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doi: 10.20043/j.cnki.MPM.202309285
  • 接收时间：2023-09-14
  • 首发时间：2026-03-18
  • 出版时间：2024-07-25
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  • 收稿日期：2023-09-14
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2023年政府资助临床医学优秀人才培养项目(ZF2023004)
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    1.华北理工大学护理与康复学院， 河北 唐山 063200
    2.华北理工大学临床医学院
    3.华北理工大学附属医院

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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