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背景 人类行为改变对诸如心脏病、脑卒中、癌症、糖尿病、慢性肺病和关节炎等非传染性疾病的预防和管理至关重要.行为改变包括减少吸烟、酗酒和不健康的饮食以及增加体力活动和提高对医嘱的依从度等.然而,目前的行为干预效果仍然有限.目的 探讨如何利用行为改变理论和行为的生物医学决定因素知识提高行为干预的有效性.方法 有选择性的综述权威性文献.结果 首先,以卒中的二级预防为例,阐明在非传染性疾病中改变不健康行为的可能性和障碍.第二,以糖尿病患者行为改变为例阐明,如果应用行为改变理论精心制定干预方案,行为干预的有效性可以得到提高.第三,以骨关节炎患者的体力锻炼为例阐明,为保障行为干预的安全有效,行为的生物医学决定因素应予以考虑.结论 根据行为改变理论精心设计干预方案,并充分考虑行为的生物医学决定因素可以提高行为干预的有效性.行为改变理论和生物医学知识应相互结合而不是孤立应用,才能制定更加有效的行为干预方案.“,”Background Changing human behavior is of major importance in the prevention and management of noncommunicable diseases,such as such as heart disease,stroke,cancer,diabetes,chronic lung disease and arthritis.Tobacco use,the harmful use of alcohol and unhealthy diets need to be reduced,while physical activity and adherence to medical advice need to be improved.The effectiveness of current behavioral interventions is somewhat limited,however.Objective To explore how the effectiveness of behavioral interventions can be improved by using theory on behavior change and by using knowledge on biomedical determinants of behavior.Methods This is a selective review of authoritative literature.Results First,the opportunities and barriers for behavior change in noncommunicable diseases are illustrated taking secondary prevention in stroke as an example.Second,if interventions are carefully planned using theory on behavior change,the effectiveness of behavioral interventions can be improved.This is illustrated using behavior change in diabetes.Third,biomedical determinants of behavior need to be taken into account,to ensure that behavioral interventions are effective and safe.Physical exercise in osteoarthritis is cited as an example.Conclusion The effectiveness of behavioral interventions can be improved (i) if interventions are carefully planned using theory on behavior change,and (ii) if knowledge on biomedical determinants of behavior is taken into account.Instead of an isolated application behavioral and biomedical knowledge needs to be integrated in order to develop more effective behavioral interventions.