Effects Of TTM-oriented Individualized Intervention Based On WeChat On The Acoustic Treatment Compliance Of Patients With Chronic Subjective Tinnitus

Objective:This paper studys the factors influencing the sound treatment of patients with chronic subjective tinnitus,and implements the TTM-oriented individualized intervention based on WeChat to improve the compliance of patients’ acoustic treatment,and then to improve the tinnitus and its accompanying symptoms as well as to improve the quality of life of patients.Methods:The research was divided into two stages:1.Qualitative ResearchThe method of semi-structured interview was used to investigate the status and influence factors of the acoustic treatment of 12 patients who met the criteria and the relevant data was collected.Then the method of qualitative research was used to analyze the data and draw the conclusion,which could provide the basis for the corresponding intervention plan.2.Quantitative ResearchAccording to the result of qualitative research,using the convenience sampling to get 84 cases of chronic tinnitus patients meeting the standard in the otolaryngology clinic of the hospital from 2017.3 to 2017.5.Then order the number for the patients by registration order and use the random number table method to make the number as the control group and the observation group,respectively,42 cases.Routine nursing wasused for the control group and the observation group,but the observation group was added up the TTM-oriented individualized intervention based on WeChat.Using the questionnaire of acoustic treatment compliance to compare the two groups of patients when the patient revisited in 3,6 months later.On the day of the visit and the next visit of3,6 months later,ask the patients to fill in the tinnitus disability,anxiety and depression scale.And compare the improvement of tinnitus and concomitant symptom for the two groups of patients.The statistical software SPSS was used for the data entry and analysis.Results:(1)In the qualitative research stage,four types of factors that influencing the sound treatment performance of patients with chronic tinnitus were summarized,which were patient factors,medical staff factors,social factors,and treatment plan factors.The appeal which expected the medical staff providing the long-term guidance and support was most requested.In this,this paper proposed to improve the treatment compliance of patients by implementing the TTM-oriented individualized intervention with the medium WeChat.(2)Finally,80 patients were included in the study(41 cases for the observation group,and 39 cases for control group).Before the intervention,the two groups in age,sex,occupation,education,marital status,tinnitus laterality,tinnitus loudness,tinnitus disability scale dimensions,anxiety and depression scale had no statistical difference in score(P>0.05).(3)The nonparametric test was adopted to compare the sound treatment compliance of the two groups of patients at different time-point.The results showed that there was no statistically significant difference(P>0.05)in the acoustic treatment compliance of the two groups after 3 months by intervention,and there was statistically significant difference(P<0.01)in the acoustic treatment compliance of the two groups after 6months by intervention.The compliance rate in the observation group was significantly better than that in the control group.(4)The repeated measurement variance was adopted to analyze the tinnitus disability scale score of different time-point for the two groups of patients,and the result showed that the time effect of tinnitus disability scale score of patients interacted with the group effect.The further single effect analysis showed that there was statistically significant difference(P<0.001)in the time effect of tinnitus disability scale score of patients,namely,tinnitus disability scale score of patients changed with time.The results of the grouping effect were shown that there was statistically significant difference(P<0.01)in tinnitus disability scale score after 6 months by intervention.Tinnitus disability scale score of the observation group was lower than that in the control group,therefore,the degree of tinnitus in the observation group was lower than that in the control group.(5)The repeated measurement variance was adopted to analyze the anxiety and depression scale score of different time-point for the two groups of patients,and the result showed that the time effect of anxiety and depression scale score of patients interacted with the group effect.The further single effect analysis showed that there was statistically significant difference(P<0.001)in the time effect of anxiety and depression scale score of patients,namely,anxiety and depression scale score of patients changed with time.The results of the grouping effect were shown that there was statistically significant difference(P<0.05)in anxiety and depression scale score after 3,6 months by intervention.Anxiety and depression scale score of the observation group was lower than that in the control group,therefore,tinnitus had little effect on the observation group.Conclusion:(1)Acoustic treatment compliance of patients with chronic subjective tinnitus is affected by many factors,such as patients,medical staff,society,treatment plan,etc.Individualized intervention should be implemented according to the patient’s specific situation.(2)It can carry out extended nursing service based on network platform andimprove the compliance of patients’ treatment.(3)Implementing the TTM-oriented individualized intervention based on WeChat can help patients to better perform acoustic treatment,thus reducing the adverse effects of tinnitus and its accompanying symptoms on patients to improve the quality of life of patients.