互联网医疗下个案管理在中青年高血压患者中的应用效果

Application Effect of Case Management Under Internet Healthcare Condition in Young and Middle-aged Patients with Hypertension

目的分析互联网医疗下个案管理在中青年高血压患者中的应用效果。方法选取2016年1月—2017年6月上海市嘉定区安亭医院收治的中青年高血压患者100例,采用随机数字表法分为对照组和研究组,每组50例。对照组患者给予高血压分级管理,研究组患者给予互联网医疗下个案管理;两组患者均连续干预6个月。比较两组患者干预前后血压、总胆固醇、三酰甘油及自我效能评分,干预后血压达标率、治疗依从性评分、疾病认知率、健康行为改善情况、健康调查简表(SF-36)评分及生活满意度量表(SWLS)评分。结果 (1)干预前两组患者收缩压(SBP)、舒张压(DBP)、总胆固醇、三酰甘油及自我效能评分比较,差异无统计学意义(P>0.05);干预后研究组患者SBP、DBP、总胆固醇、三酰甘油低于对照组,自我效能评分高于对照组(P<0.05)。(2)干预后研究组患者血压达标率,治疗依从性评分,高血压认知率,按时服药、戒烟限酒、体育锻炼、合理膳食、情绪稳定、治疗不适与医护联系者所占比例高于对照组(P<0.05);两组患者高脂血症认知率比较,差异无统计学意义(P>0.05)。(3)干预后研究组患者生理职能评分、社会功能评分、总体健康评分及SF-36总分高于对照组(P<0.05)。(4)干预后研究组患者SWLS评分高于对照组(P<0.05)。结论互联网医疗下个案管理可有效降低中青年高血压患者血压及总胆固醇、三酰甘油,提高患者血压控制效果、治疗依从性、疾病认知水平及生活质量,改善患者自我健康管理能力及健康行为。

Objective To analyze the application effect of case management under internet healthcare condition in young and middle-aged patients with hypertension.Methods From January2016to June2017,a total of100young and middle-aged patients with hypertension were selected in Anting Hospital of Jiading District,Shanghai,and they were divided into control group and study group according to random number table,each of50cases.Patients in control group received three-stage management of hypertension,while patients in study group received case management under internet healthcare condition;both groups continuously treated for6months.Blood pressure,TC,TG and self-efficacy score before and after intervention,blood pressure control rate,treatment compliance score,illness cognition ratio,improvement of healthy behaviors,SF-36score and Satisfaction with Life Scale(SWLS)score after intervention were compared between the two groups.Results(1)No statistically significant differences of SBP,DBP,TC,TG or self-efficacy score was found between the two groups before intervention(P>0.05);after intervention,SBP,DBP,TC and TG in study group were statistically significantly lower than those in control group,while self-efficacy score in study group was statistically significantly higher than that in control group(P<0.05).(2)After intervention,blood pressure control rate,treatment compliance score,cognitive rate of hypertension,proportion of patients taking medicine on time,quit smoking and limited drinking,keeping physical exercise,keeping rational diet,keeping stale emotion and keeping touch with medical workers when found discomfort caused by treatment in study group were statistically significantly higher than those in control group(P<0.05);no statistically significant difference of cognitive rate of hyperlipidaemia was found between the two groups(P>0.05).(3)Physiological role score,social function score,general health score and SF-36score in study group was statistically significantly higher than that in control group after intervention(P<0.05).(4)SWLS score in study group was statistically significantly higher than that in control group after intervention(P<0.05).Conclusion In young and middle-aged patients with hypertension,case management under internet healthcare condition can effectively reduce the blood pressure,TC and TG,improve the control effect of blood pressure,treatment compliance,illness cognition and quality of life,self-health management ability and healthy behaviors.