Intervention Study On Hospital-home Transitional Care In Patients Of Asthma Under The Background Of Medical Community

Research Purpose:This study is aim to explore the intervention effect of hospital-home transitional care(TC)in patients with asthma under the background of medical community,so as to provide empirical reference and practical basis for clinical intervention of transitional care for patients with asthma.Research Methods:Consulting domestic and foreign literature of TC,taking the guideline for asthma management and prevention of 2019 GINA and the consensus of experts on self-management of patients with bronchial asthma as the standard,selecting the health empowerment theory as the theoretical basis,and combining with the status quo of Huzhou Medical Community,the contents of TC for asthma patients were combed,and the basic framework of hospital-home TC for patients with asthma dominated by nurses was drawn up.Finally,through the discussion of the expert meeting,the intervention content of nursing in the transitional period of this study was established.Sixty patients with asthma hospitalized in a medical and health care group in Huzhou from December 2019 to December 2020,according to the block random method,were randomly divided into four groups according to the seasons(winter group from December to February;spring group from March to May;summer group from June to August;autumn group from September to November);the subjects in each group were randomly divided into two groups by dark box drawing method.The control group was given routine pre-discharge education of the respiratory department and telephone follow-up,and the experimental group was intervened according to the content of hospital-home TC.In this study,patients’ self-care ability,asthma control level and quality of life were taken as the main outcome indicators(these indicators were measured before discharge,1 month and 2 months after discharge),and the use of medical and health resources is the secondary outcome index.SPSS24.0 was used for data analysis and processing,p<0.05 indicates that there is a significant difference in the data between the two groups.Research Results:(1)Self-care agency : Pairwise comparison at different time points showed that the average difference of self-care ability between the experimental group and the control group at any two time points was statistically significant(P<0.001),indicating that with the extension of intervention time,there were differences in patients’ self-care ability;There was no obvious difference in self-care ability between the two groups before discharge and one month after discharge(P>0.05),but,two months after discharge,the TC intervention group was significantly higher than the control group,and the difference was statistically significant(P<0.001).(2)Asthma control level: There was no significant difference in asthma control level between the two groups before discharge(P>0.05);The TC intervention group was significantly higher than the control group(P<0.05),and the average differences between the two groups at one month and two months after discharge were 0.901 and 1.733 respectively.Obviously,the difference between the two groups was more significant two months after discharge.(3)Asthma quality of life: There was no significant difference in the quality of life of asthma between the two groups before discharge(P>0.05),but the average differences between the two groups at 1 month and 2 months after discharge were 8.275 and 20.274 respectively,which were significantly lower in the control group than those in the TC intervention group(P<0.001).The difference was more significant 2 months after discharge.(4)Utilization of medical resources: After the intervention,88.9% of the patients in the TC intervention group were revisited,while 64.3% in the control group,and there was a significant difference in the number of required revisits between the two groups(P<0.05).There was no significant difference in the number of non-appointment outpatient service,emergency department,readmission and hospitalization days between the two groups(P>0.05).Research Conclusion:Hospital-home transitional care can improve the self-care ability,asthma control level and asthma quality of life of patients,and the effect of 2 months after intervention is more significant than that of 1 month after intervention.Secondly,nursing intervention during the transitional period can also increase the number of re-visits as required.