Application of 4R crisis management combined with the health belief model in the prevention and control of venous thromboembolism in stroke patients

Background and objectives

Stroke patients have a high incidence of venous thromboembolism (VTE). Improving the prevention and control rates of VTE in stroke patients can enhance their quality of life. The aim of this study was to analyze the effect of 4R crisis management combined with the health belief model in the prevention and control of VTE in stroke patients.

Methods

A randomized controlled trial was conducted on 86 stroke patients in the neurosurgery department of a tertiary hospital in Wuhan. The control group was treated with the routine VTE prevention and control strategy, while the experimental group was treated with 4R crisis management combined with the health belief model. The primary outcome measures were the incidence rates of deep vein thrombosis and pulmonary thromboembolism, while the secondary outcome measures were the Short Form Health Belief Model Scale score, medical quality evaluation, and stroke patients’ health behavior scale score. The statistical analysis methods included t-tests and non-parametric tests.

Results

After the intervention, the incidence rate of deep vein thrombosis in the control group was 14.6% (6/41), while in the experimental group it was 2.4% (1/41). The difference was statistically significant (χ² = 3.905, P = 0.048). The incidence rates of pulmonary thromboembolism in both groups were 0%. The scores of all dimensions of the Short Form Health Belief Model Scale in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05, P < 0.01). The medical quality for each item showed that the experimental group performed better than the control group, with the difference being statistically significant (P < 0.05, P < 0.01). The scores on the stroke patients’ health behavior scale in the experimental group were higher than in the control group, except for responsibility, tobacco, and alcohol (P < 0.01).

Conclusions

The application of 4R crisis management combined with the health belief model could effectively improve the health beliefs and behaviors of VTE prevention and control in stroke patients. It could also improve the quality of nursing and reduce the incidence of VTE. Future research may build on these findings to further explore the long-term effects and refine the intervention methods.

Full text:

https://www.xiahepublishing.com/3067-6150/NSSS-2025-00018

The study was recently published in the Neurosurgical Subspecialties.

Neurosurgical Subspecialties (NSSS) is the official scientific journal of the Department of Neurosurgery at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. NSSS aims to provide a forum for clinicians and scientists in the field, dedicated to publishing high-quality and peer-reviewed original research, reviews, opinions, commentaries, case reports, and letters across all neurosurgical subspecialties. These include but are not limited to traumatic brain injury, spinal and spinal cord neurosurgery, cerebrovascular disease, stereotactic radiosurgery, neuro-oncology, neurocritical care, neurosurgical nursing, neuroendoscopy, pediatric neurosurgery, peripheral neuropathy, and functional neurosurgery.

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