Effects Of Hospital-community-family Continuous Care On Quality Of Life In Patients With Rheumatoid Arthritis

ObjectiveThrough the questionnaire survey of rheumatoid arthritis patients in Taiyuan City(Rheumatoid Arthuritis,RA),to understand the current situation of quality of life,fatigue degree and psychological condition of RA patients in this area,to analyze the correlation between fatigue degree and quality of life of RA patients,and to explore the influence of hospital-community-family continuous nursing intervention program on the quality of life,psychological condition and fatigue degree of RA patients.Methods1.In this study,the convenience sampling method was used to strictly enforce the inclusion exclusion criteria.From December 2018 to March 2019,196 patients with RA who met the requirements in the Department of Rheumatology Immunology of a third-class hospital in Taiyuan,Shanxi Province,were investigated by means of general data questionnaire,SF-36 health survey scale,Chinese version of fatigue multi-dimensional scale of Bristol rheumatoid arthritis patients(BRAF-MDQ),hospital depression anxiety comprehensive scale(HADS),etc.,to realize the general condition of RA patients in this area,and to analyze the correlation between fatigue degree and quality of life.2.Using the convenient sampling method,80 RA patients were selected from April2019 to June 2019 in the rheumatic immunity department of a third-class hospital in Taiyuan,Shanxi Province.The selected patients were strictly in accordance with the exclusion criteria and signed informed consent.The selected patients were grouped according to the order of admission,the first 40 were the experimental group,and the latter40 were the control group.The control group received routine nursing health education and guidance,while the intervention group received hospital-community-family continuing nursing education and guidance on the basis of routine nursing health education.Theintervention time of patients in both groups was 3 months.After the end of the experiment,the quality of life,fatigue degree,psychological status and various physiological indicators of RA patients in the two groups were compared to evaluate the intervention effect.SPSS20.0 software was used for data statistical analysis,including t test,test,spearman rank correlation and non-parametric test.Results1.Current investigation results: a total of 200 patients with RA who met the inclusion criteria were investigated,and there were 186 valid questionnaires,with an effective recovery rate of 93%,including 44 males(23.66%)and 142 females(76.34%),with an average age of(52.57±12.71)years.The mean course of disease was(6.18±3.12)years.The total score of quality of life of 186 RA patients was(52.24±16.83),their physical health was(51.49±18.49),their mental health was(52.07±17.51),and their fatigue degree was(28.87±9.76).The total score of fatigue degree in RA patients was negatively correlated with the total score of sf-36 quality of life.2.Results: a total of 80 patients with RA were included,10 of whom were lost to follow-up during the intervention,and the final number was 34 in the experimental group and 36 in the control group.The age,gender,course of disease,education level,type of medical insurance,monthly family income and complications of patients in the two groups were not statistically significant(P >0.05),and were comparable.3.Before intervention,the erythrocyte sedimentation rate(ESR),c-reactive protein(CRP),rheumatoid factor(RF),anti-cyclic citrulline(anti-ccp),VAS score and DANs28 score of the two groups of patients had no statistical significance(P >0.05).Three months after intervention,the experimental group was significantly better than the control group,with statistically significant difference(P < 0.05).4.Before intervention,the psychological scores of HADS,total scores of BRAF-MDQ and four dimensions,total scores of SF-36 and eight dimensions of the test group and the control group were not significantly different(P >0.05).Three months after the intervention,the psychological score of HADS,the total score of BRAF-MDQ and fourdimensions,the total score of SF-36 and eight dimensions of the experimental group were significantly better than that of the control group,with statistically significant differences between the two groups(P < 0.05).Conclusion1.The quality of life and fatigue degree of RA patients are mostly at the medium level,while the anxiety and depression levels are higher than the normal level.Therefore,medical staff should pay attention to the quality of life,psychological state and fatigue degree of patients,and provide personalized care and guidance to patients.There is a significant negative correlation between fatigue level and quality of life in patients with RA.Improving fatigue level of patients can effectively improve their quality of life.2.There is a significant negative correlation between fatigue degree and quality of life in RA patients,and improving the fatigue degree of patients can effectively improve their quality of life.3.Hospital-community-family continuous care can provide whole-process,continuous and seamless guidance for RA patients,and has significant effect and influence in improving the physiological indicators,life quality,fatigue and psychological conditions of RA patients.