基于双向管理的社区白内障患者管理模式研究

Study on Bi-directional Management Mode of Patients with Cataract in Community

目的评价双向管理对社区白内障患者情绪状态、躯体症状及健康状态等的影响,为患者康复提供指导。方法选取本市2014年1月至2015年8月确诊为白内障且经白内障超声乳化联合晶状体植入术老年白内障患者236例,随机分为双向管理组与常规干预组,对其分别进行双向管理干预与常规干预,每月至少随访一次,干预4个月后,分别采用自制遵医嘱问卷、Zung焦虑自评量表、抑郁自评量表、低视力者生活质量量表(CLVQOL)进行效果评价。结果干预4个月后,遵医嘱行为双向管理组比常规干预组高,生活质量评分双向管理组比常规干预组改善较大,焦虑、抑郁评分双向管理组比常规干预组下降较多,差异均有统计意义(P<0.05)。结论双向管理较常规干预组遵医嘱行为、情绪状态、生活质量好,双向管理对社区白内障患者有积极意义,值得社区、临床推广应用。

Objective To evaluate the influence of bi-directional management on emotional states, body symptoms and health status of patients with cataract in community and to provide rehabilitation guidelines. Methods From January 2014 and August 2015, 236 patients who had been diagnosed as senile cataract and had received phacoemulsification and intraocular lens implantation were included in this study and were divided into bi-directional management group and conventional intervention group randomly. After 4-month intervention, the performance evaluation was conducted through self-design questionnaire of following doctors＇ advice, Zung Self-rating Anxiety Scale, Self-rating Depression Scale and Chinese-version Low Vision Quality of Life questionnaire（CLVQOL）. Results After 4-month intervention, scores of following doctors＇ advice in bi-directional management group were higher than that in conventional intervention group, scores of life quality in bi-directional management group improved more than that in conventional intervention group, anxiety and depression scores in bi-directional management group reduced more than that in conventional intervention group, and the differences were statistically significant（P0.05）. Conclusion Compared with conventional intervention group, patients in bi-directional management have better behavior of following doctors＇ advice, emotional states and life quality. Bi-directional management has positive influence on patients with cataract in community which is worth popularizing in community and clinical practice.