Objective To construct a nursing program based on the transtheoretical model of behavior change and analyze its application effect in the treatment of patients with neuromyelitis optica spectrum disorders (NMOSD).

Methods An intervention team consisting of 7 members was established. Evidence-based medical evidence was utilized to search and screen relevant literatures from the past 5 years in databases such as PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database. Three rounds of brainstorming sessions were organized to construct a phased intervention framework (pre-contemplation, contemplation, preparation, action, and maintenance phases) based on the patients' disease status, psychological state, and sleep needs. The feasibility of the framework was validated by nursing experts. A total of 214 patients from the Third Medical Center of General Hospital of the Chinese People's Liberation Army from September 2022 to May 2024 were selected and randomly divided into control group (conventional nursing) and observation group (conventional nursing combined with phased intervention), with 107 cases in each group. The Expanded Disability Status Scale(EDSS) score, the modified Barthel index (MBI) score, the Brief Illness Perception Questionnaire (BIPQ) score, and the Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups before and after the intervention.

Results The program construction results showed a Kappa consistency of 0.81 for the intervention content at each phase. After the intervention, the EDSS score in the observation group was significantly lower than that in the control group, while the MBI score was significantly higher (P < 0.05). After the intervention, the score of each dimension and total score of the BIPQ in the observation group were significantly lower than those in the control group (P < 0.05). After the intervention, the PSQI score in the observation group was (4.87±1.10) points, which was significantly lower than (6.42±1.59) points in the control group (P < 0.05).

Conclusion The nursing program constructed based on the transtheoretical model of behavior change can effectively improve the functional status, activities of daily living, and sleep quality of patients with NMOSD.