基于健康信念模型的老年髋部骨折患者术前三联预康复参与体验的质性研究

A Qualitative Study on the Experience of Preoperative Triple Prehabilitation Participation among Elderly Patients with Hip Fractures Based on the Health Belief Model

摘要: 目的：基于健康信念模型，探讨老年髋部骨折患者参与术前三联预康复的认知、态度、影响因素及需求，为构建针对性的术前三联预康复方案提供参考。方法：采用质性研究中的描述性现象学研究方法，通过目的抽样法选取贵州省某三级甲等医院16例拟接受手术治疗的老年髋部骨折患者进行半结构式深度访谈，采用Colaizzi 7步分析法对访谈资料进行整理与分析。结果：共纳入16例受访者，提炼出4个主题：疾病威胁感知不足、预康复受益认同与现实障碍并存、自我效能不足与行动线索不足与个性化专业指导需求。结论：老年髋部骨折患者参与术前三联预康复受到疾病威胁认知、预期受益、实施障碍、自我效能及行动线索等多重因素影响。医护人员应结合患者个体特征，加强疾病风险认知沟通，提供具体、可行的运动、营养和心理支持，并通过专业指导及社会支持增强患者参与预康复的信心和主动性，促进患者主动参与术前三联预康复。

Abstract: Objective: To explore elderly patients with hip fractures’ perceptions, attitudes, influencing factors, and needs regarding participation in preoperative triple prehabilitation based on the health belief model, providing reference for developing targeted prehabilitation programs. Methods: A descriptive phenomenological approach within qualitative research was adopted. Purposeful sampling selected 16 elderly hip fracture patients scheduled for surgery from a tertiary hospital in Guizhou Province, who were interviewed using semi-structured in-depth interviews. Colaizzi’s seven-step method was used to analyze and organize the interview data. Results: Four main themes emerged: insufficient perception of disease threat, coexistence of recognition of prehabilitation benefits and practical barriers, low self-efficacy, and prominent demand for personalized nutritional guidance. Conclusion: Participation of elderly hip fracture patients in preoperative triple prehabilitation is influenced by multiple factors including perceived disease threat, anticipated benefits, implementation barriers, self-efficacy, and action cues. Healthcare providers should consider individual patient characteristics, enhance communication about disease risks, provide specific and feasible exercise, nutrition, and psychological support, and strengthen patients’ confidence and initiative through professional guidance and social support to promote active engagement in preoperative triple prehabilitation.