Discussing The Individualized Intervention Efficacy For The Chronic Constipation Patients And The Chronic Disease Management Model

Objective:Setting out the intervention plan for chronic constipation patients and conducting regular management,follow-up and guidance,to compare before and after intervention in patients with symptoms of constipation,simultaneous symptoms,use of laxative and severe degree of improvement,and evaluate the curative effect of individualized intervention.All of what we do is to discuss the mode of chronic constipation.Methods:716 cases of patients with chronic constipation which were treated in the First Hospital of Shanxi Medical University from May 2015 to October 2016 were divided into young(18-40years),middle-aged(41-65years)and elderly(> 65years)groups according to age,filled in questionnaire.We will design a comprehensive management plan for patients with individual characteristics.Patients scheme including diet,sport,defecation management which using a concept called “Chronic Disease Management(CDM)” and following-up per two weeks,total of 6 months,when following-up,we will fill “defecation diary”to record the symptoms.Bowel symptoms,simultaneous symptoms,laxative use and symptoms improvement will be compared and evaluated before and after the intervention.During the follow-up,we analyze the leading causes of constipation in order to adjust the individualized intervention plan.Results:1.The young group intervention on average working time was 1.64 ± 0.89 months,middle-aged group intervention effect on average time was 2.09 ± 0.83 months,elderly group intervention on average working time was 2.16 ± 0.83 months,three group intervention on average working time without difference(P>0.05);2.After the intervention,the constipation defecate number were significantly increased(P < 0.001),the fecal character and the difficulty degree of defecation are compared with the previous significantly decreased(P < 0.01);3.After the intervention,the simultaneous symptoms like abdominal distension,abdominal pain,belching,bad breath and inappetence also easethan before in three groups(P < 0.05);4.After the intervention,laxative dependence in the young and middle-aged patients exist obvious difference(χ2y=20.14,P<0.01;χ2m=25.60,P<0.01);But the elderly group had no obvious difference compared with before and after intervention(P>0,05);5.After intervention,the rate in patients with moderate and severe declined,the proportion of patients with mild increased:the youth patients with severe fell by 5.51%,the moderate fell by 7.80%,and the mild increased by 13.30%(χ2=3.96,P<0.05);Proportion of patients with severe CC middle-aged group fell 8.84%,the moderate fell by 5.32%,and the mild increased by 13.97%(χ2= 4.48,P < 0.05);Elderly group after the intervention of severe patients with CC also fell 6.46%,the moderate fell by 4.84%,and the mild improved by 11.29%(χ2 = 3.86,P < 0.05).Conclusion:The mode of CDM with individualized intervention can effectively relieve the bowel symptoms and simultaneous symptoms in chronic constipation,reduce using laxative,and improve the condition.