Effects of transtheoretical model-based intervention on the self-management of patients with an ostomy: A randomised controlled trial.

Abstract

To determine the effect of a transtheoretical model (TTM)-based intervention on patients with an ostomy and provide patient-centred, accessible assistance and dynamic education to improve patient self-management. Proper self-management may promote the rehabilitation of patients with an ostomy. TTM-based interventions have resulted in positive health behavioural changes. Randomised controlled trial performed according to the CONSORT guidelines. The sample comprised 55 men and 37 women (24-77years old, mean±SD=52.8±11.13years). The study settings included three tertiary hospitals in Changsha, Hunan, China. The 92 patients, recruited from August 2012 to March 2013, were randomised into a control group and an intervention group. Randomisation was done by using a block randomisation list with a block size of 4. Self-management behaviours were assessed at the baseline, 2days before discharge and after 1, 3 and 6months of follow-up. The chi-squared test, independent sample t test and repeated measures analysis of variance were used to analyse the data. Patients in the intervention group were more likely to be at the action and maintenance stages compared with those in the control group. We also observed significant improvements in the self-management ability in the process of change, the decisional balance and self-efficacy in the intervention group compared with those in the control group after four intervention sessions and up to 6months of follow-up. No serious intervention-related adverse events were observed. The TTM-based intervention had positive effects on self-management behaviours of patients with an ostomy. The TTM-based intervention had positive effects on self-management behaviours of patients with an ostomy and may provide a reference for health providers to develop behaviour promotion programmes to improve the self-management of patients with an ostomy.