Health Action Process Approach Model Research Articles

Effects of comprehensive care measures based on the HAPA model on self-care, neurotransmitters and clinical outcomes in cerebral infarction patients.

Cerebral infarction is induced by cerebral artery occlusion, resulting in ischemia, hypoxia, necrosis of brain cells in the corresponding blood supply area, and then dysfunction. Health action process approach (HAPA) model emphasizes the proposal and practice of health behavior as a whole and uses self-monitoring and encouraging ultimately developed health behavior. The present study explores the effects of comprehensive nursing measures of HAPA model on neurotransmitters, self-care ability and clinical outcomes of cerebral infarction patients. One hundred and ten patients with cerebral infarction diagnosed and treated in our hospital from July 2020 to February 2022 were included as the subjects. The subjects were randomly grouped as the control (55 patients) and the study group (55 patients) and received conventional nursing measures and additional comprehensive nursing measures of HAPA model, respectively. The patients were tested for changes in self-care ability, nerve damage [myelin basic protein (MBP), S100B, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE)] and neurotransmitter indexes [acid-soluble protein (Asp), neuropeptide Y (NPY), substance P (SP), glutamate (Glu)], respectively. The patients were considered as the good prognosis group (47 cases) and poor prognosis group (63 cases) according to the prognosis after comprehensive care. The logistic regression model was used to analyze the risk factors affecting the poor prognosis of patients with cerebral infarction. After nursing, China Stroke Scale (CSS) score, the Fugl Meyer Rating Scale (FMA) score and Barthel index were significantly higher in both groups than before nursing, and all indexes were significantly higher in the study group than in the control group (p< 0.05). The length of hospital stay was significantly shorter in the study group than in the control group (p< 0.05). Compared with before nursing, the health knowledge, self-care skills, self-responsibility and self-concept of two groups were strongly increased after nursing, and the study group had much higher indexes than the control group (p< 0.05). After nursing, the levels of MBP, S100B, GFAP, NSE, Asp, NPY, SP and Glu in both groups were largely decreased, and more significant decrease was found in the study group (p< 0.05). Age, body mass index (BMI), hypertension history, coronary heart disease history and National Institutes of Health Stroke Score (NIHSS) score after treatment were significantly different between the good and poor prognosis groups (p< 0.05). The prognosis of patients in the study group was 52.73%, which was significantly higher than 32.73% in the control group (p< 0.05). Age, hypertension history, and post-treatment NIHSS score were independent risk factors related to poor prognosis by logistic multiple regression analysis (p< 0.05). Comprehensive care measures of HAPA model may be used with advantage to improve the self-care ability, reduce the degree of neurological damage, and improve neurological function in cerebral infarction patients. Age, hypertension history, and NIHSS score after treatment were all risk factors related to poor prognosis.

Determinants Influenced by COVID-19 Vaccine: Employing the Health Action Process Approach and the Belief in Conspiracy Theories.

Vaccination is considered a practical approach to improving individuals' health behavior to fight against the COVID-19 pandemic. However, the currently manufactured COVID-19 vaccines can only work for a limited time. Thus, continuous vaccination intention is crucially essential. The current study explores critical factors influencing citizens' continuous vaccination intentions for COVID-19 vaccines, based on the modified health action process approach (HAPA) model and belief in a conspiracy theory. A questionnaire survey was used to collect data from people living in Taiwan. Three hundred ninety responses were employed for the final investigation. The findings suggest that openness to experience, government communication, and pandemic knowledge significantly influence vaccination intention, but the COVID-19 threat is insignificant. Second, descriptive norms play a significant role in promoting vaccination intention. Third, a belief in conspiracy theories negatively influences vaccination intention. Fourth, vaccination behavior positively influences both perceived benefits and value co-creation. Fifth, perceived benefits positively impact value co-creation and continuous vaccination behavior. Finally, value co-creation has a significant influence on continuous vaccination behavior. The proposed model, the key contributor to the current study, confirms citizens' continuous vaccination intentions in a three-stage procedure: motivation to volitional, volitional to behavior, and volitional to continuous vaccination intention.

Factors influencing adherence to lifestyle prescriptions among patients with nonalcoholic fatty liver disease: A qualitative study using the health action process approach framework.

Lifestyle modifications aimed at weight loss have been introduced as a cornerstone of nonalcoholic fatty liver disease (NAFLD) management. However, very few patients follow the doctor's prescription to change their lifestyle to achieve weight loss in the real world. The purpose of this study was to use the Health Action Process Approach (HAPA) model to examine the factors that affect adherence to lifestyle prescriptions among patients with NAFLD. Semi-structured interviews were conducted with patients with NAFLD. Reflexive thematic analysis and framework analysis were used to determine naturally identified themes and allocate them to theoretically driven domains. Thirty adult patients with NAFLD were interviewed, and the identified themes were mapped directly onto the constructs of the HAPA model. This study revealed that key barriers to adhering to lifestyle prescriptions are related to the coping strategy and outcome expectation constructs of the HAPA model. For physical activity, conditional limits, lack of time, symptoms such as fatigue and poor physical fitness, and fear of sports injury are the primary barriers. Barriers to diet are mainly diet environment, mental stress, and food cravings. Key facilitators for adherence to lifestyle prescriptions include developing simple and specific action plans, coping strategies to flexibly deal with obstacles and difficulties, receiving regular feedback from doctors to improve self-efficacy, and using regular tests and behavior recording to enhance action control. Future lifestyle intervention programs should pay particular attention to the planning, self-efficacy, and action control-related constructors of the HAPA model to promote the adherence of patients with NAFLD to lifestyle prescriptions.

Social media promotion, risk perception, and parental support for adolescent girls’ HPV vaccination: Taking consideration of future consequences and sexual attitudes as moderators

HPV vaccine hesitancy in Asia is unique compared to western countries. Concerning whether social media promotion about HPV vaccine will be related with parental support for Chinese adolescent girls, we investigated the correlation among social media promotion, risk perception of HPV vaccine and parental support. Through the theoretical lens of Health Action Process Approach model (HAPA), we found that social media promotion could reduce the risk perception of HPV vaccine and promoted parental supportive decision, and risk perception played a mediation role between social media information exposure to vaccine and parental support. Consideration of future consequences has been found to play a moderating role between social media promotion and risk perception, and parents’ sexual attitudes moderated the effect of social media promotion on parental support. Implications of the findings are discussed.

Social-cognitive correlates of expectant mothers’ safe communication behaviour: Applying an adapted HAPA model

To improve patient safety in obstetrics, patients should perform safe communication. However, there is a lack of attempts in targeting expectant mothers. Behaviour change theories can potentially be applied to safe communication behaviour to understand and target contributing factors. The objective of this study was to apply the Health Action Process Approach (HAPA) to obstetric patients’ safe communication behaviour to understand underlying mechanisms of social-cognitive HAPA variables. N = 424 expectant mothers from two university hospitals participated in a cross-sectional survey which was the baseline of a larger randomized controlled trial. The proposed HAPA model with iterative theory-driven extensions were fitted to the data via path modelling. Fit indices were compared. Post-hoc analyses asserted sufficient statistical power. An adapted HAPA model fitted the data best. The adaptation concerned two sequential mediation pathways: The association of intention and safe communication behaviour was mediated by coping self-efficacy and via social support and action planning. Congruent with theory, intention and action planning, mediated by social support and coping self-efficacy, emerged as core factors contributing to safe communication behaviour. The HAPA model can be applied to safe communication behaviour in obstetric patients. Hence, future interventions to enhance expectant mothers’ safe communication should be based on behaviour change theories like the hereby tested HAPA model.

Abstract WMP14: Status And Influencing Factors Of Rehabilitation Exercise Compliance In Young And Middle-aged Patients With Hemorrhagic Stroke Based On The Hapa Model: A Multi-center Cross-sectional Survey

Background and Purpose: Exercise rehabilitation is the preferred rehabilitation therapy for stroke patients, but exercise compliance of patients is generally low. The study aimed to investigate and analyze the status and influencing factors of rehabilitation exercise compliance in young and middle-aged patients with hemorrhagic stroke. Methods: Convenience sampling method was adopted to select 397 young and middle-aged hemorrhagic stroke patients from three hospitals in central, eastern and northern China from July 2021 to January 2022 in accordance with the geographical classification standards of the National Bureau of Statistics and multi-center research cooperation. According to the Health Action Process Approach(HAPA), the general data survey scale, stroke functional exercise compliance Scale, exercise self-efficacy scale, exercise plan scale, stroke health belief scale and self-care ability scale were used for cross-sectional investigation. Results: The total score of exercise compliance in young and middle-aged stroke patients was (43.46±9.58), and the average compliance rate was 77.60%, which was in the middle level. Multivariate regression analysis showed that total score of exercise self-efficacy, total score of exercise program, perceived susceptibility, perceived severity, perceived benefit, perceived obstacle, health motivation and self-efficacy were the influencing factors of exercise compliance in young and middle-aged stroke patients ( P &lt; 0.05). Conclusions: According to the HAPA model, clinical medical staff should accurately evaluate the rehabilitation exercise stage of patients, and formulate and implement stroke rehabilitation exercise strategies according to the actual situation of patients and various possible influencing factors, so as to improve the exercise compliance of patients, improve their functional status, and further improve their quality of life.

Theory-based behavioral change interventions to improve periodontal health.

Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.

Retracted: Effect of Rehabilitation Nursing under the Guidance of the Health Action Process Approach Model on Perioperative Nursing Effect of Artificial Hip Arthroplasty: Effect on Promoting Quality of Life and Postoperative Rehabilitation.

[This retracts the article DOI: 10.1155/2022/1247002.].

건강행동과정접근(HAPA)모델을 적용한 여가시간 신체활동(LTPA) 참여자의 행동과정 검증

건강행동과정접근(HAPA)모델을 적용한 여가시간 신체활동(LTPA) 참여자의 행동과정 검증

THE FIT OF THE HAPA MODEL TO THE EXPERIENCE OF EXERCISING AFTER STROKE: A DEDUCTIVE CONTENT ANALYSIS

Abstract Sustained physical activity is recommended for secondary stroke prevention. Persons with stroke leave rehabilitation having learned exercises to reduce disability. However, once discharged, people may be on their own to navigate psychological, emotional, social, and physical challenges of maintaining those activities and starting new ones. The Health Action Process Approach (HAPA) provides a framework for understanding how self-efficacy differs depending on where a person is in the process of engaging in physical activity. The purpose of this study was to assess the qualitative fit of the HAPA model to the experience of exercise after discharge from formal stroke rehabilitation using a deductive (directed) content analysis approach. Interviews with 12 stroke survivors were analyzed deductively using the HAPA model concepts task self-efficacy, coping self-efficacy, and recovery self-efficacy to create the analysis matrix. In this sample, a period of psychological adjustment interfered with maintaining exercise and included anxiety, depression, embarrassment, and fear of falling that affected motivation and intention to exercise. Experiences with physical activity and exercise as a child and routines prior to the stroke were factors influencing task, coping, and recovery self-efficacy and ease of dealing with interruptions in exercise, including the discharge from formal rehabilitation. The findings support the qualitative fit of the HAPA model with the experience of exercise after having a stroke. A HAPA model framed intervention is being developed to support the transition from formal rehabilitation support to living in the community.

The Codevelopment of "My Kidneys & Me": A Digital Self-management Program for People With Chronic Kidney Disease.

Health care self-management is important for people living with nondialysis chronic kidney disease (CKD). However, the few available resources are of variable quality. This work describes the systematic codevelopment of "My Kidneys & Me" (MK&M), a theory-driven and evidence-based digital self-management resource for people with nondialysis CKD, guided by an established process used for the successful development of the diabetes education program MyDESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed, DESMOND). A multidisciplinary steering group comprising kidney health care professionals and researchers and specialists in the development of complex interventions and digital health provided expertise in the clinical and psychosocial aspects of CKD, self-management, digital health, and behavior change. A patient and public involvement group helped identify the needs and priorities of MK&M and co-design the resource. MK&M was developed in 2 sequential phases. Phase 1 involved the codevelopment process of the MK&M resource (content and materials), using Intervention Mapping (IM) as a framework. The first 4 IM steps guided the development process: needs assessment was conducted to describe the context of the intervention; intervention outcomes, performance objectives, and behavioral determinants were identified; theory- and evidence-based change methods and practical strategies to deliver change methods were selected; and program components were developed and refined. Phase 2 involved the adoption and adaptation of the existing MyDESMOND digital platform to suit the MK&M resource. The needs assessment identified that individuals with CKD have multiple differing needs and that delivering a self-management program digitally would enable accessible, tailored, and interactive information and support. The intended outcomes of MK&M were to improve and maintain effective self-management behaviors, including physical activity and lifestyle, improve knowledge, promote self-care skills, increase self-efficacy, and enhance well-being. This was achieved through the provision of content and materials designed to increase CKD knowledge and patient activation, reduce health risks, manage symptoms, and improve physical function. Theories and behavior change techniques selected include Self-Management Framework, Capability, Opportunity, Motivation Behavior model components of Behaviour Change Wheel and taxonomy of behavior change techniques, Health Action Process Approach Model, Common Sense Model, and Social Cognitive Theory. The program components developed comprised educational and behavior change sessions, health trackers (eg, monitoring blood pressure, symptoms, and exercise), goal-setting features, and forums for social support. The MyDESMOND digital platform represented an ideal existing platform to host MK&M; thus, the MyDESMOND interface and features were adopted and adapted for MK&M. Applying the IM framework enabled the systematic application of theory, empirical evidence, and practical perspectives in the codevelopment of MK&M content and materials. Adopting and adapting a preexisting platform provided a cost- and time-efficient approach for developing our digital intervention. In the next stage of work, the efficacy of MK&M in increasing patient activation will be tested in a randomized controlled trial.

Predicting Physical Activity in Survivors of Breast Cancer: the Health Action Process Approach at the Intrapersonal Level.

Benefits have been established for regular physical activity (PA) and exercise after breast cancer, but a decline of PA has also been a reported result of breast cancer diagnosis and treatments. The Health Action Process Approach (HAPA) model has been shown to predict various health behaviors, but few studies have tested it at the intrapersonal level. The aim of the present study was to test whether the HAPA constructs that are well confirmed at the interpersonal level also hold at the intrapersonal level in a group of women survivors of breast cancer. PA behaviors (N = 338) by nine survivors of breast cancer were observed for 6weeks, and the associations between the HAPA constructs and PA over time were examined. Participants completed a questionnaire with the HAPA constructs related to PA behavior (direct step count and self-reported). A multilevel model of behavior prediction found that optimistic beliefs about ability to initiate and maintain PA (self-efficacy) were positively related to intentions to be active, and these intentions predicted plans to be active. PA was directly and positively predicted by planning and by confidence in the ability to resume PA after a break. Self-efficacy and planning are associated with PA behavior within women survivors of breast cancer over time, which was not the case for the outcome expectancies, social support, and action control at this intrapersonal level. A multilevel approach for psychological predictors of PA can be useful in grounding interventions for survivors of breast cancer.

Design and Psychometric Evaluation of Mammography Behavior Predicting Scale (MBPS)

Background: Breast cancer disease is an important public health trouble in the world. Over the past 2 decades, incidences of breast cancer among Iranian women have shown an alarmingly rapid increase. Mammography screening can lead to early detection and management of breast cancer and it also plays an important preventive role in decreasing breast cancer, especially among women over 40 years old. Objectives: This paper aims at reporting the psychometric properties of a questionnaire on mammography behavior based on health action process approach (HAPA) model. Methods: This cross-sectional study was performed between May and September 2017, and was attended by 400 women aged 40 years and older, in comprehensive health service centers in Iran. The research subjects were selected by multi-stage cluster sampling. The instrument was designed basis on the constructs of HAPA and current literature. The scale’s psychometric properties were examined by exploratory factor analysis (EFA), infraclass correlation coefficient (ICC), and Cronbach’s alpha. Results: The results showed 45 items of the questionnaire, 41 items had important item-to-total correlations (P &lt; 0.05), and they were placed in 8 factors that contributed 60.88% of the scale variance. Conclusions: The research findings contribute to the reliability and validity of the HAPA model for predictively evaluating mammography goals.

Psychosocial Mediators of Web-Based Interventions for Promoting a Healthy Lifestyle Among Chinese College Students: Secondary Analysis of a Randomized Controlled Trial.

BackgroundWeb-based multiple health behavior change (MHBC) interventions have demonstrated effectiveness in promoting physical activity (PA) and fruit and vegetable consumption (FVC) among Chinese college students. However, there is limited research examining their effects on promoting a healthy lifestyle (ie, adhering to both PA and FVC behavioral recommendations) among Chinese college students. In addition, the salient psychosocial mediators of successful MHBC interventions need to be researched.ObjectiveThis study aims to examine the effectiveness of a previous 8-week web-based MHBC program for promoting a healthy lifestyle and enhancing the psychosocial determinants (intention, self-efficacy, planning, and social support) of behavior change among Chinese college students. Furthermore, the study aims to identify whether changes in these psychosocial determinants mediate intervention effectiveness on the immediate and sustained lifestyle changes.MethodsThis was a secondary analysis for a 3-arm randomized controlled trial. Chinese college students (N=552) were randomly assigned to 1 of 3 groups: a PA-first group (4-week PA intervention followed by 4-week FVC intervention), an FVC-first group (4-week FVC intervention followed by 4-week PA intervention), and a placebo control group. The intervention content was designed based on the health action process approach model. Data for analyses were collected at baseline (T0), postintervention assessment (T1), and 12-week follow-up assessment (T2).ResultsAt baseline, 13.9% (77/552) of the participants maintained a healthy lifestyle. After 8 weeks, more (200/552, 36.2%) participants achieved a healthy lifestyle. PA-first and FVC-first groups were, respectively, 3.24 times and 5 times more likely to adopt a healthy lifestyle than the control group at T1. After 12 weeks, 35.5% (196/552) of the participants adopted a healthy lifestyle. Intervention groups were approximately 2.99 times (PA first) and 4.07 times (FVC first) more likely to adopt a healthy lifestyle than the control group at T2. Intervention effects favored both intervention groups in self-efficacy and planning for PA and in intention and planning for FVC compared with the control condition. In addition, changes in PA self-efficacy and FVC intention mediated intervention effectiveness on the immediate lifestyle change after 8 weeks. Changes in FVC intention were identified as a salient mediator for facilitating sustained lifestyle change after 12 weeks.ConclusionsThis study provides empirical evidence for the effectiveness of an 8-week theory- and web-based MHBC intervention program on promoting a healthy lifestyle, self-efficacy and planning for PA, and intention and planning for FVC among Chinese college students. These research findings add new knowledge to the underlying psychosocial mechanisms of successful MHBC interventions. Overall, this study has considerable implications for future web-based MHBC research and practice in terms of addressing PA self-efficacy and FVC intention and helping students to adopt and maintain a healthy lifestyle independently of whether PA or FVC is addressed first.Trial RegistrationClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949

Using the Health Action Process Approach to predict blood donation intentions and return behavior following a vasovagal reaction for whole blood and plasma donors.

To inform the development of interventions to retain donors following a vasovagal reaction (VVR), the aim of this study is to use the Health Action Process Approach (HAPA) to identify predictors of intentions to re-donate and actual return behavior among whole blood (WB) and plasma donors who experienced a VVR. A total of 1136 WB donors (Mage =32.4 ± 12.5 years; 73.4% female) and 1141 plasma donors (Mage =36.5 ± 14.4 years; 73.3% female) completed an online survey after experiencing a VVR. Two hierarchical regression analyses were conducted for each donation type. In the first analysis, donation intentions were regressed onto the motivational HAPA constructs and social support. In the second analysis, donor return within 6months was regressed onto social support, intentions, and the volitional HAPA constructs. The motivational and social support variables accounted for 47.2% of the variance in intentions to return in WB donors and 15.7% in plasma donors. For both groups, task self-efficacy, positive and negative outcome expectancies, and social support were significant predictors of intentions to return. Intentions and action planning were significant predictors of donor return in both groups, and recovery self-efficacy was significant for plasma only. The HAPA model can provide guidance to blood collection agencies to design phase-specific and individually-focused interventions to retain WB and plasma donors following a VVR.

Behaviour change techniques that constitute effective planning interventions to improve physical activity and diet behaviour for people with chronic conditions: a systematic review

ObjectivesAction planning is a brief and effective behaviour change technique (BCT) to improve physical activity (PA) and diet behaviour (DB). This study aimed to identify critical BCTs and mechanisms of...

Linking Exercise Intention to Exercise Action: The Moderating Role of Self-Efficacy.

As physical exercise benefits both physical and psychological health of college students, it is important to promote the habit of physical exercise among them. This study adopted the Health Action Process Approach (HAPA) model to understand the exercise intention–action link and determine the moderating role of self-efficacy. We recruited 242 students from a university in China and asked them to complete a six-wave survey. The survey results indicated that exercise intention was positively related to both coping planning and action planning, which pave the way to performing the action of exercise. However, such mediation effects varied under conditions of self-efficacy. Participants with high self-efficacy exhibited stronger relationships between intention and planning, and between planning and action. The study results suggest that planning has a time-lagged mediation effect in the relationship between intention and action. Additionally, the findings shed light on the moderating role of self-efficacy, which can be useful in developing health-promotion strategies for college students.

Effectiveness of an online application of the health action process approach (HAPA) theory on oral hygiene intervention in young adults with fixed orthodontic appliances: a randomized controlled trial

BackgroundThis randomized controlled trial aimed to evaluate the effectiveness of an online application based on HAPA theory on oral hygiene promotion in young adults with fixed orthodontic appliances.MethodsA WeChat mini-program (called “Clean Teeth”) based on HAPA theory was designed beforehand to improve oral-health behaviors and oral hygiene, and 44 participants aged 17–29 with fixed orthodontic appliances were recruited. Participants of the experimental group (n = 22) received the “Clean Teeth” mini-program, in addition to care as usual, and the control group (n = 22) only received routine oral health education. Data were collected during three orthodontic check-ups: baseline (T0), 6 weeks of follow-up (T1), and 12 weeks of follow-up (T2). All participants completed questionnaires assessing oral health behaviors and the psychosocial factors of the HAPA model and accepted the clinical examinations involving the dental plaque index and the gingival bleeding index.ResultsAfter a 12-week intervention, the plaque index and gingival bleeding index in the experimental group were significantly lower than that in the control group. The psycho-social parameters of social effects, expected outcomes, and action control were improved significantly after treatment, among which social effects increased significantly only in the experimental group but not in the control group.ConclusionsThe HAPA theory-based mini-program had positive effects on oral-health behavior promotion and oral hygiene among young adults with fixed orthodontic appliances.Trial registration This study was retrospectively registered in the Chinese Clinical Trial Registry, with the number CTR2200056731, dated 12/02/2022. http://www.chictr.org.cn/index.aspx.

Predicting physical activity in kidney transplant recipients: an application of the Health Action Process Approach model

ABSTRACT Despite numerous physical, psychological, and social benefits of physical activity (PA), few kidney transplant recipients (KTRs) positively participate in PA. It is essential to understand the influencing factors of PA in KTRs. This study aimed to apply the Health Action Process Approach (HAPA) model to explore the influencing factors of PA in KTRs. This was a prospective study involving 320 participants. Pre-actional self-efficacy, outcome expectancies, risk perception, social support, PA intention, and demographic and clinical data were measured at Time 1. Coping self-efficacy, planning, recovery self-efficacy, and PA behavior were assessed 3 months later. The hypothesized relationships were examined by structural equation modeling. Findings revealed significant direct effects of pre-actional self-efficacy, negative outcome expectancies, positive outcome expectancies, and social support on intention. Planning and recovery self-efficacy were significant predictors of PA. The HAPA model provided a validated and useful framework for predicting the factors influencing PA behavior in KTRs.

Effect of Rehabilitation Nursing under the Guidance of the Health Action Process Approach Model on Perioperative Nursing Effect of Artificial Hip Arthroplasty: Effect on Promoting Quality of Life and Postoperative Rehabilitation.

Objective To explore the influence of rehabilitation nursing under the guidance of Health Action Process Approach (HAPA) model on the perioperative nursing effect of artificial hip replacement and to analyze the effect of this nursing model on the quality of life and postoperative rehabilitation of patients undergoing artificial hip replacement. Methods A total of 200 patients with hip arthroplasty treated in our hospital from January 2019 to July 2021 were enrolled. The patients were randomly assigned into the control group and study group. The former received routine nursing, and the latter received rehabilitation nursing under the guidance of the HAPA model. Nursing satisfaction, pain score, Harris hip function score, timed stand-up-walk test, MBI score, and quality of life score were compared. Results First of all, we compared the nursing satisfaction. In the study group, 86 cases were very satisfied, 8 cases were satisfied, and 6 cases were general; the satisfaction rate was 100%. In the control group, 48 cases were very satisfied, 22 cases were satisfied, 12 cases were general, and 18 cases were dissatisfied; the satisfaction rate was 82.0%. The nursing satisfaction in the study group was higher compared to that in the control group (P < 0.05). Secondly, we compared the pain scores. Before nursing, there exhibited no significant difference (P > 0.05). After nursing, the pain score of the two groups increased. Moreover, the pain score of the study group at discharge and 1 month, 3 months, and 6 months after operation was lower compared to that of the control group (P < 0.05). Before nursing, there exhibited no significant difference in the Harris hip joint function score (P > 0.05). After nursing, the Harris hip function score increased. Furthermore, the Harris hip function score of the study group at discharge and 1 month, 3 months, and 6 months after operation was higher compared to that of the control group (P < 0.05). In terms of the timed stand-up-walking test, there exhibited no significant difference before nursing (P > 0.05). After nursing, the time of the timed stand-up-walk test in both groups decreased. And the timed stand-up-walk test at discharge and 1 month, 3 months, and 6 months after operation in the study group was lower compared to that in the control group (P < 0.05). Compared with the MBI scores, there exhibited no significant difference before nursing (P > 0.05). After nursing, the MBI scores increased. Of note, the MBI scores of the study group at discharge and 1 month, 3 months, and 6 months after operation were higher compared to those of the control group (P < 0.05). Finally, we compared the scores of life quality. Before nursing, there exhibited no significant difference (P > 0.05). After nursing, the scores of life quality decreased. The scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower compared to those in the control group (P < 0.05). Conclusion The perioperative rehabilitation nursing program of artificial hip replacement for the elderly based on the HAPA model is feasible, which can effectively enhance the functional recovery of hip joint, promote the ability of self-care of daily life, relieve pain and anxiety, and help to achieve dynamic balance and gait stability in the early stage. The rehabilitation program is better than routine nursing. As a new social cognitive model, the HAPA model is applied to the rehabilitation nursing environment of hip replacement from the aspect of social cognitive behavior, which can help to enhance the rehabilitation behavior of elderly patients, playing an important role in the rehabilitation effect of perioperative nursing.