身心科日間病房病人體重控制改善專案－跨理論模式之應用

慢性身心科病人因體重過重問題已構成健康威脅，本日間病房2015年1月25位日間住院病人進行分析，其中18位體重過重，11位意識到自己體重過重，有減重意願但無具體計畫及行動，另7人不覺體重過重，無減重動機，分析體重過重主要因素為運動量及營養知識不足，專案小組針對原因並依據行為改變跨理論策略採以下解決方法：1.籌畫健康促進衛生講座2.設計健康管理手冊3.修訂動態課程活潑性4.規劃支持性減重環境，專案實施後18位參與者平均BMI由27kg/m2減低至25.5kg/m2，營養認知正確率從36.1%提升至66.8%。建議未來可運用行為改變跨理論於體重控制，以增進自我效能及改變行為態度。

關鍵字

體重控制；身心科日間病房住院病人；行為改變歷程；跨理論模式

並列摘要

The overweight problem of chronic psychiatric patients threatens their health. In Januray 2015, 25 patients of the psychiatric day ward were recruited. Among them, 18 had overweight. The 11 out of 18 were aware of overweight and motivation for weight reduction with no specific plan or action. The other 7 patients were not aware of overweight and had no motivation of losing weight. Reasons for overweight among them include lack of exercise and knowledge of nutrition. The research team implemented. Resolution measures by transtheoretical model included: (1) arranging health education classes; (2) designing health managementhandbook; (3) revising creative exercise instrument; (4) creating an environment friendly to weight loss. After the intervention, the average BMI of 18 overweight patients decreased from 27 to 25.5 Kg/m2, and accuracy of knowledge of diet increased from 36.1% to 66.8%. The results implied nurses can provide appropriate intervention by applying transtheoretical model. Through understanding the behavioral change process, we can promote the effectiveness of weight loss programs.

並列關鍵字

weight control ； psychiatric day care inpatients ； processes of behavior change ； transtheoretical model

參考文獻

Huang M, Lee H, Ou L, Wu P, Ho P, Lai Y, et al：Prevalence and correlates of obesity among chronic psychiatric patients.Taiwanese Journal of Psychiatry 2009；23：126-134.