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  4. Vol 7, Issue 2, 2026

Development of a Nurse-Led Intrinsic Capacity Intervention Protocol Based on the Health Action Process Approach for Older Adults with Stroke

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DOI: 10.23977/medsc.2026.070218 | Downloads: 1 | Views: 52

Author(s)

Rui Yuan 1, Yawen Wu 1, Binbin Yang 1, Xinyue Zhang 1, Houming Si 1, Qianqian Niu 1, Pan Zhang 1, Lina Gao 2

Affiliation(s)

1 College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Avenue, Caofeidian New City, Tangshan, Hebei, 063200, China
2 Central Supply Room, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, Hebei, 050051, China

Corresponding Author

Lina Gao

ABSTRACT

This study aimed to develop an intrinsic capacity (IC) intervention protocol for older adults with stroke based on the Health Action Process Approach (HAPA). A preliminary protocol was drafted through literature retrieval, evidence extraction, and team discussion, with the HAPA used to organise the behavioural process and the five IC domains (locomotion, vitality, cognition, psychological capacity, and sensory capacity) used to specify intervention content. Two rounds of Delphi consultation were conducted with 16 experts from hospitals and nursing education institutions, and item importance, coefficient of variation (CV), expert authority, and Kendall's coefficient of concordance were analysed. The response rate was 100% in both rounds, with an expert judgement coefficient of 0.900, a familiarity coefficient of 0.731, and an authority coefficient of 0.816. Kendall's W increased from 0.235 in round 1 to 0.317 in round 2 (both P < 0.001), and the final-round CVs ranged from 0.000 to 0.136. The final protocol contained 3 primary indicators, 10 secondary indicators, and 20 tertiary indicators, which covered risk perception, outcome expectancy, self-efficacy, action planning, coping planning, home practice, follow-up, peer support, and recovery after interruption. The protocol offers a structured, Delphi-informed intervention plan that links HAPA-based behaviour change processes with domain-specific IC content for older adults with stroke, although further feasibility testing is needed before effectiveness evaluation.

KEYWORDS

Stroke; Intrinsic Capacity; Health Action Process Approach; Intervention Protocol; Delphi Method

CITE THIS PAPER

Rui Yuan, Yawen Wu, Binbin Yang, Xinyue Zhang, Houming Si, Qianqian Niu, Pan Zhang, Lina Gao. Development of a Nurse-Led Intrinsic Capacity Intervention Protocol Based on the Health Action Process Approach for Older Adults with Stroke. MEDS Clinical Medicine (2026). Vol. 7, No.2, 148-154. DOI: http://dx.doi.org/10.23977/medsc.2026.070218.

REFERENCES

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[7] Kleindorfer, D.O., Towfighi, A., Chaturvedi, S. et al. (2021) 2021 Guideline for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline from the American Heart Association/American Stroke Association. Stroke, 52, e364-e467.
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