关键词: 炎症性肠病；克罗恩病；溃疡性结肠炎；运动；障碍因素；审查指标

Abstract: Objective: To analyze the barrier factors for exercise management in patients with Inflammatory Bowel Disease (IBD), and to formulate coping strategies, providing a basis for clinical practice. Methods: Using the knowledge transformation framework as the theoretical framework, review indicators were developed and review methods were determined based on evidence. A review was conducted on 154 inpatients with IBD, 34 nurses, 2 physicians, and 2 exercise prescription therapists from gastroenterology department of a tertiary grade A hospital in Zhenjiang between September 1 and December 31, 2023, to identify gaps between clinical practice and the evidence. Guided by the social cognitive theory, interviews were conducted with 17 patients and 8 healthcare professionals. Directed content analysis method was used to analyze the barrier and facilitating factors of introducing evidence into clinical practice, and then corresponding strategies were formulated. Results: A total of 20 audit indicators were formulated, of which 18 had a compliance rate less than 60%. Barriers analysis showed that patients mainly had behavioral dilemma of "fear of exercise, knowing but not doing", error outcome expectation, insufficient self-efficacy, weak self-regulation ability and lack of social support. At the medical staff level, there is a lack of system and insufficient training. The formed strategies for implementation included forming a multidisciplinary team, optimizing the venue and conducting training, formulating individualized prescriptions and conducting follow-ups; enhancing patient compliance through diversified education, home monitoring, family and group support. Conclusion: There is a big gap between the clinical status and the best evidence of exercise management in IBD patients. Nurses should implement coping strategies to facilitate the implementation of exercise management, thereby improving patient outcomes.

Key words: Inflammatory Bowel Disease; Crohn's disease; ulcerative colitis; physical activity; barriers; audit indicators