基于信息化的动态多维管理模式对改善淋巴水肿患者居家自我护理的应用效果

Application of dynamic multi-dimensional management model based on informatization on improving home self-care of patients with lymphedema

目的:探讨基于信息化的动态多维管理模式对改善淋巴水肿患者居家自我护理的效果。方法:采用前后历史非同期对照,选取2018年1-6月行淋巴水肿综合消肿治疗的患者80例作为对照组,采用临床常规护理措施和健康宣教;2018年7-12月就诊的同类患者80例作为干预组,在对照组的基础上采用基于信息化的动态多维管理模式进行全程管理。比较2组患者的依从性和生命质量。结果:干预组患者居家正确测量肢体周径、生活规律良好、正确徒手淋巴引流方向、绷带包扎、功能锻炼、执行18条建议的依从性分别为95.0%(76/80)、87.5%(70/80)、97.5%(78/80)、95.0%(76/80)、100.0%(80/80)、87.5%(70/80),优于对照组的77.5%(62/80)、75.0%(60/80)、80.0%(64/80)、70.0%(56/80)、75.0%(60/80)、50.0%(40/80),差异有统计学意义(χ2值为4.103~26.182,P<0.05或0.01)。在治疗1个疗程,且经过3个月居家自我护理后,干预组生命质量如角色功能、躯体功能、情绪功能、社会功能评分分别为(75.44±2.78)、(80.11±3.01)、(78.25±2.78)、(79.93±5.43)分,均优于对照组的(66.25±2.58)、(75.88±3.57)、(65.16±2.47)、(62.78±4.01)分,差异有统计学意义(t值为8.09~31.50,P<0.01)。结论:基于信息化的动态多维管理模式可以提高综合消肿治疗淋巴水肿患者参与居家自我护理的依从性和生命质量,更好地满足居家护理的需求。

Objective To explore the effect of dynamic multi-dimensional management model based on informatization on improving the home self-care of lymphedema patients.Methods A total of 80 patients who received lymphedema combined detumescence treatment from January 2018 to June 2018 were selected as the control group.From July 2018 to December 2018,80 patients were treated as the intervention group,and the whole process was managed on the basis of the control group using the dynamic multidimensional management mode based on informatization.Patients'compliance and quality of life were compared between the two groups.Results The intervention group patients'compliance was better than control group,correctly measure the circumference of limbs,the law of life that occupy the home was good,correct manual lymph drainage direction,bandages,functional exercise,18 standards compliance,respectively,95.0%(76/80),87.5%(70/80),97.5%(78/80),95.0%(76/80),100.0%(80/80),87.5%(70/80),better than that of control group were 77.5%(62/80),75.0%(60/80),80.0%(64/80),70.0%(56/80),75.0%(60/80),50.0%(40/80),difference was statistically significant(χ2 values were 4.103-26.182,P<0.05 or 0.01).After a course of treatment and 3 months of home-based self-care,the scores of role function,physical function,emotional function and social function of the quality of life in the intervention group were(75.44±2.78),(80.11±3.01),(78.25±2.78),(79.93±5.43),which were better than those of the control group(66.25±2.58),(75.88±3.57),(65.16±2.47),(62.78±4.01),with statistically significant differences(t values were 8.09,31.50,P<0.01).Conclusions The dynamic multi-dimensional management model based on informationization and doctor-patient participation can improve the compliance and quality of life of patients participating in home-based self-care and better meet the needs of home-based nursing.