健康行为改变整合理论在健康促进中的应用研究进展

摘要/Abstract

摘要： 《健康中国行动（2019—2030）》指出,须引导群众树立正确的健康观念,形成有利于健康的生活方式及环境,但我国居民多处于被动健康管理而缺乏主动健康意识,目前仍存在大量不健康行为,影响居民健康。健康行为改变整合理论（integrated theory of health behavior change,ITHBC）作为行为改变领域的一项综合性理论,是可以帮助干预人员分析行为影响因素和制定行为改变干预方案的有力工具。该理论涵盖知识和信念、自我调节及社会促进3种结构以及近、远二期结果,旨在促进与慢性病管理和健康促进相关的健康行为改变。本文基于既往国内外研究,对ITHBC的起源与概念、内容框架及在健康促进领域应用现状进行综述,并在此基础上得出启示,以期为ITHBC的发展提供参考,为该理论在健康促进领域的应用提供思路。

关键词: 健康行为改变整合理论, 健康促进, 健康行为, 综述

Abstract: The "Healthy China Action(2019-2030)" points out that it is necessary to guide the masses to establish correct health concepts,form a healthy lifestyle and environment. However,many Chinese residents are in passive health management and lack active health awareness. Currently,there are still a large number of unhealthy behaviors,and the incidence of diseases among residents remains high.The integrated theory of health behavior change(ITHBC),as a comprehensive theory in the field of behavior change,is a powerful tool that can help intervention personnel in analyzing behavior influencing factors and developing behavior change intervention plans. The theory includes three constructs and two outcomes：knowledge and beliefs,self-regulation,social facilitation,proximal and distal outcomes,to promote health behavior change related to chronic disease management and health promotion. This paper reviews the origin,concept,content framework,and current application status of ITHBC in the field of health promotion based on previous domestic and foreign research. Based on this,insights are drawn to provide reference for the development of ITHBC and ideas for its application in the field of health promotion.

Key words: Integrated theory of health behavior change, Health promotion, Health behavior, Review

中图分类号:

R193

杨柠嘉, 李颐, 周亮, 黄睿, 李菁, 郑冰. 健康行为改变整合理论在健康促进中的应用研究进展. [J]职业与健康, 2025, 41(20): 2862-2866.

YANG Ningjia, LI Yi, ZHOU Liang, HUANG Rui, LI Jing, ZHENG Bing. Research progress on the application of integrated theory of health behavior change in health promotion. [J]OCCUPATION AND HEALTH, 2025, 41(20): 2862-2866.

参考文献

[1] 卢文云,张伟国,黄忠明.主动健康视阈下我国体医融合健康促进体系优化研究[J].天津体育学院学报,2023,38(6):703-711.
[2] 健康中国行动推进委员会.健康中国行动(2019—2030年)[EB/OL].(2019-07-15)[2023-11-08].http://www.gov.cn/xinwen/2019-07/15/content_5409694.htm.
[3] 毕圣贤,陈迎春,李萍,等.健康储蓄理念下主动健康长效机制[J].中国公共卫生,2024,40(8):1028-1032.
[4] 刘明波,王增武,樊静,等.《中国心血管健康与疾病报告2023》要点解读[J].中国心血管病研究,2024,22(7):577-593.
[5] RYAN P.Integrated theory of health behavior change:background and intervention development[J].Clin Nurse Spec,2009,23(3):161-170.
[6] RYAN P,WEISS M,TRAXEL N,et al.Testing the integrated theory of health behaviour change for postpartum weight management[J].J Adv Nurs,2011,67(9):2047-2059.
[7] MA Y,HAN X,LI W,et al.Self-reported vaccination-related behavior patterns among healthcare workers and the association with self-directed learning frequency:A nationwide cross-sectional survey[J].Front Public Health,2022,10:951818.
[8] CLAEYS J,GURVICH O,HADIDI N N.Association between family history of stroke and stroke risk:A community survey[J].Western J Nurs Res,2020,42(12):1174-1181.
[9] 乔悦,黄霞,贾培培,等.老年慢性心力衰竭患者居家容量管理体验的质性研究[J].护理学杂志,2023,38(4):108-111.
[10] 程玲,郑凤,惠梦湲,等.慢性心力衰竭患者居家用药安全影响因素的质性研究[J].中华护理杂志,2024,39(14):1713-1718.
[11] SHEN A,WU P,QIANG W,et al.Breast cancer survivors' experiences of barriers and facilitators to lymphedema self-management behaviors:A theory-based qualitative study[J].J Cancer Surviv,2025,19(2):642-658.
[12] 杨乔越,余雅琪,余艮珍,等.慢性肾脏病青少年过渡期准备体验的质性研究[J].护理学杂志,2024,39(9):116-120.
[13] HEINRICH K M,CARLISLE T,KEHLER A,et al.Mapping coaches' views of participation in crossfit to the integrated theory of health behavior change and sense of community[J].Fam Community Health,2017,40(1):24-27.
[14] RYAN P,PUMILIA N J,HENAK B,et al.Development and performance usability testing of a theory-based,computerized,tailored intervention[J].Comput Inform Nurs,2009,27(5):288-298.
[15] MAIERLE D,RYAN P.Evaluation of satisfaction and use of electronic intervention for behavior change[J].Comput Inform Nurs,2011,20(11):622-629.
[16] RYAN P,MAIERLE D,CSUKA M E,et al.Computer-based intervention to enhance self-management of calcium and vitamin D intake in women[J].Western J Nurs Res,2013,35(8):986-1010.
[17] 周柳吟,严娇,何琦,等.基于ITHBC的个体化呼吸训练及营养支持在COPD患者中的应用研究[J].中国急救复苏与灾害医学杂志,2024,19(2):242-246.
[18] 李思璇,郭思彤,马艳梅.基于行为改变整合理论的健康教育在胃癌根治术患者饮食管理中的应用[J].护理实践与研究,2023,20(8):1117-1121.
[19] 李洁.老年抑郁症住院患者营养现状调查分析与干预研究[D].新乡:新乡医学院,2021.
[20] 杨惠莉,赵建伟,蒋静媛,等.基于健康行为改变整合理论的乳腺癌患者患肢功能康复干预方案的应用研究[J].护士进修杂志,2024, 39(1):42-46.
[21] 肖红利.基于健康行为改变整合理论的护理干预结合体感互动康复训练对创伤性下肢骨折患者康复锻炼积极性、健康行为及功能恢复的影响[J].临床医学研究与实践,2023,8(5):172-174.
[22] 王莹.基于健康行为改变整合理论的护理干预在COPD患者肺康复运动中的应用研究[D].开封:河南大学,2022.
[23] 高瑾.基于健康行为改变整合理论的护理干预对改善孕妇身体活动水平的效果研究[D].蚌埠:蚌埠医学院,2023.
[24] 李秋侠,张红艳,杨亚莉,等.基于ITHBC的综合康复护理在产后盆底康复护理中的应用[J].海南医学,2022,33(24):3239-3242.
[25] 杨婧.健康行为改变整合理论干预对宫颈癌根治术后患者盆底锻炼的影响[D].郑州:郑州大学,2022.
[26] 杨雪晴.健康行为改变整合理论在早期宫颈癌术后合并盆底功能障碍性疾病患者盆底肌锻炼中的应用研究[D].无锡:江南大学,2020.
[27] 龚英,石国凤.基于健康行为改变整合理论的护理干预对居家帕金森患者日常生活能力及自我效能的影响[J].中国疗养医学,2020, 29(9):901-904.
[28] World Health Organization.WHO report on the global tobacco epidemic,2023:protect people from tobacco smoke[R].Geneva:WHO,2023.
[29] SHARMA P,TRANBY B,KAMATH C,et al.A Christian faith-based Facebook intervention for smoking cessation in rural communities (FAITH-CORE):Protocol for a community participatory development study[J].JMIR Res Protoc,2023,12(1):e52398.
[30] 谢贵华,成忠莎,万艳平,等.基于健康行为改变整合理论的健康教育在心脏机械瓣膜置换术后患者延续护理中的应用[J].护士进修杂志,2023,38(1):73-76.
[31] 林永兰.基于健康行为改变整合理论为导向的延续护理对冠心病患者二级预防治疗依从性的影响[J].中国医药指南,2023,21(29):39-42.
[32] 魏利娇.基于ITHBC的健康教育对缺血性脑卒中偏瘫患者功能锻炼依从性的应用研究[D].天津:天津中医药大学,2020.
[33] BAO Y,WANG C,XU H,et al.Effects of an mHealth intervention for pulmonary tuberculosis self-management based on the integrated theory of health behavior change:Randomized controlled trial[J].JMIR Public Hlth Sur,2022,8(7):e34277.
[34] 胡哲,雷丹丹,赵益,等.基于健康行为改变整合理论的护理干预对糖尿病视网膜病变患者的影响[J].中华护理杂志,2024,59(3):300-307.
[35] 史丽妙,赵奇江,徐瑾,等.健康行为改变整合理论联合助推策略在高尿酸血症患者健康管理中的应用[J].中华全科医学,2024,22(7):1166-1170.
[36] 陈转红,陈慧,王丹,等.以健康行为改变整合理论为导向的护理模式联合叙事护理在急性脑卒中患者中的应用效果[J].川北医学院学报,2023,38(8):1145-1149.
[37] 李琴,马雪儿,杨雪霞,等.基于健康行为改变整合理论的自我管理方案在非酒精性脂肪肝病患者中的应用研究[J].护士进修杂志,2024,39(13):1435-1440.
[38] 钱晨莹,濮怡,赵志,等.健康行为改变整合理论在乙肝肝硬化失代偿患者健康教育中的应用效果[J].中国健康教育,2021,37(2):179-182.
[39] 罗勤,廖力,刘凤刚,等.基于健康行为改变整合理论的永久心脏起搏器植入患者自我管理方案的构建及应用研究[J].保健医学研究与实践,2022,19(3):37-41.
[40] 王俊超.基于ITHBC的结直肠癌造口患者自我管理微信小程序的构建及应用研究[D].长春:吉林大学,2023.
[41] 周晴,朱利红,王芳,等.基于健康行为改变整合理论的健康教育对颌面部外伤整形患者创面愈合的影响[J].中国美容医学,2024,33(4):172-175.
[42] 徐兵.基于行为改变整合理论的健康教育对冠心病患者运动恐惧的应用研究[D].济南:山东大学,2023.
[43] 郭丽敏.基于行为改变整合理论的健康教育对老年髋关节置换患者跌倒恐惧的应用效果研究[D].天津:天津中医药大学,2020.
[44] 汤娜,蒋晓红,黄媛.基于健康行为整合理论的护理干预对脑卒中患者心理状态、自我效能和生活质量的影响[J].齐鲁护理杂志,2020, 26(7):62-64.
[45] 杨媛媛,李小燕,叶春慧,等.基于健康行为改变整合理论的全生命周期护理干预对维持性血液透析患者衰弱和生活质量的影响[J].中国医药导报,2024,21(13):138-141.
[46] 吴培.基于健康行为改变整合理论护理干预对老年糖尿病衰弱患者的影响[D].衡阳:南华大学,2021.
[47] 马翠,解红文.基于健康行为改变整合理论的移动健康干预对孕妇体重管理的影响[J].广西医学,2020,42(4):505-508.