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| 基于理论域框架的老年膝骨关节炎康复锻炼依从性影响因素的质性研究 |
| Qualitative research on influencing factors of compliance of rehabilitation exercise for elderly patients with knee osteoarthritis based on theoretical domain framework |
| 投稿时间：2025-12-03 修订日期：2026-01-06 |
| DOI： |
| 中文关键词: 膝骨关节炎；康复锻炼依从性；影响因素；理论域框架 ；质性研究 |
| 英文关键词: knee osteoarthritis; Compliance of rehabilitation exercise; Influencing factors; Theoretical domain framework; Qualitative research |
| 基金项目:安徽省高等学校科学研究项目（哲学社会学科），体卫融合背景下老年人功能性踝关节不稳的发病特点及运动康复方案的研究（2023AH051892）；蚌埠医科大学校级项目，基于行为改变轮理论的老年膝骨关节炎人群的运动康复方案构建及初步应用 |
| 作者 | 单位 | 邮编 | | 王璐 | 蚌埠医科大学 | 232000 | | 王换换 | 如皋市人民医院护理部 | | | 岳建兴* | 安徽省蚌埠医科大学第二附属医院 | 233000 |
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| 中文摘要: |
| 摘 要 目的 基于理论域（TDF）框架探讨老年膝骨关节炎（KOA）康复锻炼依从性的影响因素，旨在构建干预方案提供理论支撑? 方法 于2025年1月～2025年3月，采取目的抽样法，选取18例就诊于蚌埠医科大学第二附属医院康复科的KOA患者进行半结构化访谈。采用定向内容分析法，基于TDF进行资料编码、分析与主题提炼。 结果 共识别出8个关键TDF理论域，分为障碍因素与促成因素两类：①障碍因素（4个）：知识域（疾病与运动认知偏差）、技能域（缺乏技能胜任力和发展机会）、社会角色与认同域（家庭角色冲突）、环境及资源域（物理环境制约与健康资源可及性不足 ）；②促成因素（4个）：信念域（康复效果信念）、强化域（既往成功经验的反馈）、乐观域（心态积极）、社会影响域（群体氛围的正面效应）。 结论 老年KOA患者康复锻炼的依从性受障碍和促成因素影响，分属于TDF理论的不同域，且存在复杂的交互作用。加之老年人群的特殊性，因此需加强患者运动与疾病间的认知联系，推进跨学科合作以及巩固正向推动因素，是解决依从性的关键。 |
| 英文摘要: |
| Abstract Objective To explore the influencing factors of compliance of rehabilitation exercise for elderly patients with knee osteoarthritis (KOA) based on the theoretical domain (TDF) framework, aiming at constructing an intervention program and providing theoretical support. Methods From January, 2025 to March, 2025, we selected 18 KOA patients from the Department of Rehabilitation of the Second Affiliated Hospital of Bengbu Medical University for semi-structured interviews. Directed content analysis method is used to encode, analyze and refine the data based on TDF framework. Results Eight key TDF theoretical domains were identified, which were divided into two categories: obstacle factors (4): knowledge domain (cognitive deviation between disease and sports), skill domain (lack of skill competence and development opportunities), social role and identity domain (family role conflict), environment and resource domain (physical environment constraints and insufficient accessibility of health resources); ② Contributing factors (4): belief domain (belief in rehabilitation effect), reinforcement domain (feedback from previous successful experience), optimism domain (positive mentality) and social influence domain (positive effect of group atmosphere). Conclusion The compliance of elderly KOA patients with rehabilitation exercise is influenced by obstacles and contributing factors, which belong to different domains of TDF theory and have complex interactions. In addition, the particularity of the elderly makes the problem more prominent. Therefore, strengthening the cognitive connection between patients' exercise and diseases, promoting interdisciplinary cooperation and consolidating positive driving factors are the keys to solving compliance. |
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