Objective  To explore the application of the transtheoretical model combined with WeChat follow-up on the levels of lipid levels, health knowledge of lipid management, attitudes and behaviours in acute ischemic stroke patients with concomitant dyslipidemia.

Methods  Data of patients diagnosed with acute ischemic stroke concomitant with dyslipidemia admitted to the Neurology Department of Qinghai Provincial People's Hospital between December 2022 and November 2023 were collected and randomly divided into the combined intervention group and the conventional control group. The combined intervention group received transtheoretical model combined with WeChat follow-up intervention, while the conventional control group received traditional health education. The differences of blood lipid biochemical indicators [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB)], health knowledge-attitude-behavior level of blood lipid management, intervention compliance, nursing satisfaction, and psychological status between two groups were compared.

Results  A total of 120 patients with acute ischemic stroke complicated by dyslipidemia were included, with 60 in the combined intervention group and 60 in the conventional control group. Before treatment, there were no statistically significant differences in baseline characteristics between the two groups (P>0.05). After three months of intervention, serum levels of TC, TG, LDL-C, and ApoB were significantly lower in both groups compared to pre-intervention levels (P<0.05), while serum levels of ApoA1 and HDL-C increased (P<0.05). Patients in the combined intervention group exhibited significantly lower levels of TC, TG, LDL-C, and ApoB compared to the conventional control group, with significantly higher levels of ApoA1 and HDL-C (P<0.05). Knowledge, attitude and behavioural scores for lipid management were elevated in both groups, with each score significantly higher in the combined intervention group than in the conventional control group (P<0.05). After 3 months of intervention, the compliance and nursing satisfaction of patients in the combined intervention group were significantly higher than those in the conventional control group (P<0.05). The scores of somatization, obsessive-compulsive symptoms, interpersonal relationships, depression, anxiety, hostility, fear, paranoia, and psychoticism in the combined intervention group were significantly lower than those in the conventional control group (P<0.05).

Conclusion  The application of the transtheoretical model combined with WeChat follow-up can effectively improve the lipid profiles of patients with acute ischemic stroke concomitant with dyslipidemia. It also can enhance patients' health knowledge, attitudes, and behavioral patterns regarding lipid management, increases intervention adherence and nursing satisfaction, and ameliorate psychological well-being.

1.乔梦婷,陈梦霞,张静文,等. 缺血性脑卒中患者血脂异常管理最佳证据总结[J]. 海军军医大学学报, 2023, 44(12): 1392-1398. [Qiao MT, Chen MX, Zhang JW, et al. Summary of best evidence for management of blood lipid abnormalities in patients with ischemic stroke[J]. Academic Journal of Naval Medical University, 2023, 44(12): 1392-1398.] DOI: 10.16781/j.CN31-2187/R.20230645.

2.Ghose T. Lipoprotein a-Lp(a)[J]. Indian Heart J, 2024, 76 Suppl 1(Suppl 1): S117-S120. DOI: 10.1016/j.ihj.2023.12.010.

3.Tu WJ, Wang LD, Special Writing Group of China Stroke Surveillance Report. China stroke surveillance report 2021[J]. Mil Med Res, 2023, 10(1): 33. DOI: 10.1186/s40779-023-00463-x.

4.虞莉莎,刘新靓,宋康,等. 中国脑卒中环境危险因素的系统评价[J]. 医学新知, 2023, 33(3): 173-208. [Yu LS, Liu XL, Song K, et al. Environmental risk factors for stroke in China: a systematic review[J]. Yixue Xinzhi Zazhi, 2023, 33(3): 173-208.] DOI: 10.12173/j.issn.1004-5511.202209017.

5.李洁,张萍,黄楷森,等. 脑卒中高危人群用药依从性及对预后影响的多中心前瞻性研究[J]. 华西医学, 2022, 37(6): 823-829. [Li J, Zhang P, Huang KS, et al. Multicenter prospective study on medication adherence and its impact on prognosis in high-risk population of stroke[J]. West China Medical Journal, 2022, 37(6): 823-829.] DOI: 10.7507/1002-0179.202202037.

6.龙世燕,李铭,涂双燕,等. 行为改变联合传统健康教育在2型糖尿病合并脑梗死患者中的应用效果[J]. 中国医药导报, 2019, 16(4): 173-176, 181. [Long SY, Li M, Tu SY, et al. Application effect of behavior change combined with traditional health education in patients with type 2 diabetes mellitus complicated with cerebral infarction[J]. China Medical Herald, 2019, 16(4): 173-176, 181.] DOI: CNKI:SUN:YYCY.0.2019-04-042.

7.Ahn S, Chung JW, Crane MK, et al. The effects of multi-domain interventions on cognition: a systematic review[J]. West J Nurs Res, 2022, 44(12): 1134-1154. DOI: 10.1177/ 01939459211032272.

8.曾超超. 跨理论模型的应用及展望[J]. 国际护理学杂志, 2016, 35(23): 3173-3177. [Zeng CC. The application and prospects of transtheoretical model[J]. International Journal of Nursing, 2016, 35(23): 3173-3177.] DOI: 10.3760/cma.j.issn.1673-4351.2016.23.002.

9.李钦楠,吴健雄,李慧,等. 知识转化理论在健康促进中的应用[J]. 中国循证医学杂志, 2022, 22(5): 595-599. [Li QN, Wu JX, Li H, et al. The application of knowledge translation theory in health promotion[J]. Chinese Journal of Evidence-Based Medicine, 2022, 22(5): 595-599.] DOI: 10.7507/1672-2531.202201046.

10.林蓓蕾,梅永霞,梁莉莉,等. 微信平台随访对脑卒中患者服药自我管理水平的应用效果[J]. 中华行为医学与脑科学杂志, 2019, 28(1): 12-16. [Lin BL, Mei  YX, Liang LL, et al. Impact of WeChat-assisted follow-up on the self-administer medication capability of stroke survivors[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2019, 28(1): 12-16.] DOI: 10.3760/cma.j.issn.1674-6554.2019.01.002.

11.徐淑娟,李秋妍,洪花艳,等. 微信平台随访模式对农村脑卒中患者的作用[J]. 中国卫生标准管理, 2018, 9(17): 190-192. [Xu SJ, Li QY, Hong HY, et al. The role of Wechat platform follow-up model on rural stroke patients[J]. China Health Standard Management, 2018, 9(17): 190-192.] DOI: 10.3969/j.issn.1674-9316. 2018.17.093.

12.中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682.[Chinese Society of Neurology, Chinese Stroke Society. Chinese guidelines for the diagnosis and treatment of acute ischemic stroke 2018[J]. Chinese Journal of Neurology, 2018, 51(9): 666-682.] DOI: 10.3760/cma.j.issn.1006-7876.2018.09.004.

13.中国成人血脂异常防治指南制订联合委员会. 中国成人血脂异常防治指南[J]. 中国实用乡村医生杂志, 2012, 19(18): 5-15. [Joint Committee for the Formulation of Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Guidelines for the prevention and treatment of dyslipidemia in Chinese adults[J]. Chinese Practical Journal of Rural Doctor, 2012, 19(18): 5-15.] DOI: 10.3969/j.issn.1672-7185. 2012.18.003.

14.黄鑫,胡敏予,黄忆明. 血脂知识-态度-行为问卷的信度和效度检验[J]. 卫生研究, 2008, 37(2): 204-206. [Huang X, Hu MY, Huang YM. Reliability and validity test of blood lipid knowledge-attitude-behavior questionnaire[J]. Journal of Hygiene Research, 2008, 37(2): 204-206.] DOI: 10.3969/j.issn.1000-8020.2008.02.021.

15.冯爱芳,董芳芳,杨勤玲,等. 精准化护理模式在减重术后饮食管理中的应用效果[J]. 临床医学研究与实践, 2017, 2(20): 144-145. [Feng AF, Dong FF, Yang  QL, et  al. Application effect of precision nursing model in dietary management after weight loss surgery[J]. Clinical Research and Practice, 2017, 2(20): 144-145.] DOI: 10.19347/j.cnki. 2096-1413.201720071.

16.孙丽丽,卢明,王艳,等. 时效性激励模式下的延伸护理在老年慢性萎缩性胃炎癌前病变患者中的应用效果[J]. 检验医学与临床, 2024, 21(3): 321-324. [Sun LL, Lu  M, Wang Y, et al . Effectiveness of extended care in a timely incentive model in elderly patients with chronic atrophic gastritis with precancerous lesions[J]. Laboratory Medicine and Clinic, 2024, 21(3): 321-324.] DOI: 10.3969/j.issn.1672-9455.2024.03.008.

17.晋争,赵凯宾,于欢,等. 症状自评量表(SCL-90)河南省青少年区域性常模的建立和心理测量特性验证 [J]. 精神医学杂志, 2022, 35(2): 113-118. [Jin Z, Zhao KB, Yu H, et al. Establishment of regional norms for the symptom checklist-90 (SCL-90) in adolescents in Henan province and verification of psychological measurement characteristics[J]. Journal of Psychiatry, 2022, 35(2): 113-118.] DOI: 10.3969/j.issn.2095-9346. 2022.02.001.

18.Shridharan P, Nair R, Gorthi SP, et al. Effects of serum cholesterol on severity of stroke and dosage of statins on functional outcome in acute ischemic stroke[J]. Neurol India, 2023, 71(5): 923-927. DOI: 10.4103/0028-3886. 388115.

19.Zafrir B, Aker A, Naoum I, et al. Guideline-directed low-density lipoprotein cholesterol management after acute ischemic stroke: findings from a national health care service[J]. Am J Cardiol, 2023, 203: 332-338. DOI: 10.1016/j.amjcard.2023.07.032.

20.Xia Y, Liu H, Zhu R. Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: a Meta-analysis[J]. World J Clin Cases, 2023, 11(26): 6122-6131. DOI: 10.12998/wjcc.v11.i26.6122.

21.刘彦淑,任海燕. 跨理论模型在冠心病患者健康行为改变中的应用进展[J]. 中华心血管病杂志, 2019, 47(4): 331-334. [Liu YS, Ren HY. The application progress of trans-theoretical model on changing the healthy behavior of patients with coronary heart disease[J]. Chinese Journal of Cardiology, 2019, 47(4): 331-334.] DOI: 10.3760/cma.j.issn.0253-3758.2019.04.013.

22.项颖卿. 跨理论模型健康教育对老年慢性阻塞性肺疾病患者生活质量的影响[J]. 中国老年学杂志, 2018, 38(13): 3272-3275. [Xiang YQ. The impact of transtheoretical model health education on the quality of life of elderly patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Gerontology, 2018, 38(13): 3272-3275.] DOI: 10.3969/j.issn.1005-9202. 2018.13.078.

23.Gallucci L, Sperber C, Guggisberg AG, et al. Post-stroke cognitive impairment remains highly prevalent and disabling despite state-of-the-art stroke treatment[J]. Int J Stroke, 2024, 19(8): 888-897. DOI: 10.1177/ 17474930241238637.

24.卞睿华,王岚,陈勤勤,等. 首次发病住院的青年脑卒中患者心理体验的质性研究[J]. 护士进修杂志, 2023, 38(19): 1813-1816. [Bian RH, Wang L, Chen QQ, et al. Qualitative study on psychological experience of young stroke patients hospitalized for the first time[J]. Journal of Nurses Training, 2023, 38(19): 1813-1816.] DOI: 10.16821/j.cnki.hsjx.2023.19.015.