基于信息平台的慢阻肺患者自我管理模式构建及效果评价

The Construction and Evaluation of Self Management Mode for Patients with Chronic Obstructive Pulmonary Disease on the Basis of Information Platform

目的观察基于信息平台指导的慢阻肺患者自我管理对其生活质量、运动能力、抑郁、呼吸困难评分改善的效果评价.方法对60例慢阻肺患者进行为期半年的自我管理,干预组30例通过自主开发的微信平台指导督促自我管理,对照组30例参照《慢阻肺自我管理手册》自我管理;对比2组患者生活质量、运动能力、肺功能指标的改变;及干预组自我管理前、后抑郁评分、呼吸困难评分对照.结果 2组患者间性别、年龄、受教育程度、医疗费用支付方式、慢阻肺分级差异均无统计学意义(P>0.05).基于微信平台指导的慢阻肺患者自我管理能力得分高于对照组(P<0.05),出院后3个月及6个月6 min步行试验高于对照组(P<0.05).干预组自我管理前后抑郁及呼吸困难评分均有明显改变(P<0.001).出院后6个月干预组肺功能改善高于对照组(P<0.014).结论基于微信平台进行慢阻肺自我管理是一种简单、有效的模式,能给慢阻肺患者带来积极影响.

Objective To observe the effect of self-management on improving the quality of life, exercise capacity,depression and dyspnea score of patients with chronic obstructive pulmonary disease（COPD） on the basis of WeChat platform.Methods 60 patients with COPD were made to manage themselve for a period of half a year while30 cases in the intervention group were guided by self-developed WeChat platform to supervise self management in real time. 30 cases in the control group were self managed according to the self-management Manual of COPD, and the changes of quality of life, exercise ability and lung function were compared between the two groups. Also, the depression score and dyspnea score in the intervention group before and after self management were compared.Results There was no significant difference in gender,age,education level,payment mode of medical expenses,and grade of COPD between the two groups（P 〉 0.05）. The self-management ability of the patients with COPD guided by WeChat platform was higher than that of the control group（P 〈 0.05）, and the distance of six minute walk test（6 mwt） was higher than that of the control group（P 〈 0.05） for 3 months and 6 months after the discharge. The depression and dyspnea scores were significantly changed before and after the intervention in the intervention group（P 〈 0.001）. The lung function in the intervention group was better than that of the control group after 6 months discharge（P 〈 0.014）.Conclusion It is a simple and effective way to manage COPD based on WeChat platform, which can bring positive effects on the COPD patients.