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基于行为改变轮理论的嗅觉障碍患者康复训练依从性干预

Intervention to Improve Compliance with Olfactory Training in Patients with Olfactory Dysfunction Using the Behavior Change Wheel

投稿时间：2026-05-08 修订日期：2026-06-17

DOI：

中文关键词: 嗅觉障碍康复训练依从性行为改变轮护理干预嗅觉训练

英文关键词:Olfactory disorders Rehabilitation training Adherence Behaviour Change Wheel Nursing intervention Olfactory training

基金项目:

作者	单位	邮编
易伶俐	华中科技大学同济医学院附属协和医院	430000
王淼^*	华中科技大学同济医学院附属协和医院	430000

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中文摘要:

目的探讨基于行为改变轮（Behaviour Change Wheel， BCW）理论的干预方案对嗅觉障碍患者康复训练依从性与嗅觉功能改善的影响。方法选取2022年6月至2023年12月于某三甲医院耳鼻咽喉头颈外科就诊的86例嗅觉障碍患者作为研究对象，采用随机数字表法分为干预组（43例）与对照组（43例）。对照组接受常规嗅觉训练指导，干预组在常规训练基础上实施基于BCW理论构建的依从性干预方案，干预周期为16周。采用Morisky用药依从性量表（MMAS-8）评估训练依从性，使用嗅棒测试（Sniffin'' Sticks test）评估嗅觉功能变化，并记录患者的训练完成率与脱落率。对两组患者在基线期、第8周与第16周的依从性评分、嗅觉阈值（T）、气味辨别（D）、气味识别（I）及综合评分（TDI）进行比较分析。结果干预组训练完成率为93.02%（40/43），显著高于对照组的72.09%（31/43）（χ²=6.428，P=0.011）。第16周时干预组MMAS-8评分为（7.28±0.82）分，高于对照组的（5.91±1.15）分（t=6.214，P<0.001）。嗅觉功能方面，干预组第16周TDI评分为（26.85±5.24）分，较基线期（18.42±4.67）分提升8.43分，对照组TDI评分为（22.73±5.89）分，较基线期（18.56±4.82）分提升4.17分，组间差异具有统计学意义（t=3.427，P=0.001）。干预组嗅觉功能改善率为72.50%（29/40），高于对照组的48.39%（15/31）（χ²=4.392，P=0.036）。结论基于行为改变轮理论构建的依从性干预方案能够有效提高嗅觉障碍患者的训练完成率，降低脱落率，提升依从性水平，促进嗅觉功能改善，为临床康复护理提供新的理论依据与实践路径。

英文摘要:

ObjectiveTo explore the effects of an intervention program based on Behaviour Change Wheel (BCW) theory on rehabilitation training adherence and olfactory function improvement in patients with olfactory disorders.MethodsA total of 86 patients with olfactory disorders who visited the Department of Otolaryngology Head and Neck Surgery of a tertiary hospital from June 2022 to December 2023 were selected as research subjects and randomly divided into intervention group (43 cases) and control group (43 cases) using random number table method. The control group received routine olfactory training guidance, while the intervention group implemented an adherence intervention program based on BCW theory in addition to routine training, with an intervention period of 16 weeks. The Morisky Medication Adherence Scale (MMAS-8) was used to assess training adherence, and the Sniffin" Sticks test was used to evaluate changes in olfactory function. Training completion rates and dropout rates were recorded. Adherence scores, olfactory threshold (T), odor discrimination (D), odor identification (I), and composite score (TDI) were compared between the two groups at baseline, week 8, and week 16.ResultsThe training completion rate of the intervention group was 93.02% (40/43), significantly higher than that of the control group at 72.09% (31/43) (χ2=6.428, P=0.011). At week 16, the MMAS-8 score of the intervention group was (7.28±0.82) points, higher than that of the control group at (5.91±1.15) points (t=6.214, P<0.001). Regarding olfactory function, the TDI score of the intervention group at week 16 was (26.85±5.24) points, an increase of 8.43 points from baseline (18.42±4.67) points. The control group"s TDI score was (22.73±5.89) points, an increase of 4.17 points from baseline (18.56±4.82) points, with statistically significant difference between groups (t=3.427, P=0.001). The olfactory function improvement rate of the intervention group was 72.50% (29/40), higher than that of the control group at 48.39% (15/31) (χ2=4.392, P=0.036).ConclusionThe adherence intervention program based on Behaviour Change Wheel theory can effectively improve the rehabilitation training adherence of patients with olfactory disorders, promote olfactory function improvement, reduce training dropout rate, and provide new theoretical basis and practical pathways for clinical rehabilitation nursing.

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