Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China

Abstract

Objective. This study evaluated the effect of a health belief model (HBM) educational intervention on the self-perception of and complications related to disease in elderly gynaecological malignancy patients. Methods. This randomized controlled trial was conducted at the Fujian Maternal and Child Health Hospital, China. A total of 301 women aged 60 years and older who were diagnosed with gynaecological malignancies from January 2019 to August 2020 were recruited. Participants were randomly divided into the HBM education and basic nursing groups. The participants in the HBM education group received perioperative rehabilitation education based on the HBM, and the participants in the basic nursing group received routine basic nursing. Rehabilitation training compliance, psychological resilience, psychological flexibility, self-efficacy, self-care ability, and lower extremity deep venous thrombosis (LEDVT) incidence were assessed before and after the intervention. Results. Thirty-three women were excluded based on the exclusion criteria, and 268 participants were eventually included and randomly divided into two groups: 134 participants in the HBM education group and 134 participants in the basic nursing group. Before HBM education, there were no significant differences in the mean scores of psychological resilience (50.43 ± 3.29 vs. 50.55 ± 2.29, $P$  = 0.738), psychological flexibility (48.98 ± 3.45 vs. 49.29 ± 3.59, $P$  = 0.465), self-efficacy (26.49 ± 5.26 vs. 26.29 ± 6.41, $P$  = 0.781), or rehabilitation training compliance (28.4% vs. 27.8%, $P$  = 0.922) between the two groups. After HBM education, the scores of training compliance (80.6% vs. 30.1%, $P$  < 0.001), psychological resilience (55.47 ± 5.01 vs. 50.46 ± 2.62, $P$  < 0.001), psychological flexibility (56.53 ± 4.51 vs. 49.13 ± 3.62, $P$  < 0.001), self-efficacy (30.79 ± 4.56 vs. 26.41 ± 6.37, $P$  < 0.001), self-care knowledge (43.36 ± 7.60 vs. 34.05 ± 6.99, $P$  < 0.001), self-concept (29.57 ± 5.67 vs. 20.11 ± 3.86, $P$  < 0.001), self-care responsibility (27.54 ± 5.09 vs. 20.86 ± 4.53, $P$  < 0.001), and self-care skills (34.51 ± 5.62 vs. 21.62 ± 5.64, $P$  < 0.001) were higher in the HBM education group than those in the basic nursing group. Additionally, the incidence of LEDVT was lower in the HBM group than that in the basic nursing group (2.2% vs. 8.3%, $P$  = 0.027). Conclusion. This study indicated that perioperative HBM education can improve the cognition and self-care ability of elderly gynaecological malignancy patients and reduce postoperative complications.