| ObjectivesA self-management intervention model for hypertensive patients based on modern information technology,patient-centered,combined self-management of patients with medical care was established,aiming to reduce the risk of cardiovascular disease,and improve the quality of life of patients.This study aimed to address the following problems:1.To comprehensively explore the influencing factors of health-related quality of life for hypertensive patients in mountainous rural areas,in order to provide evidence-based suggestions for policy-making in rural areas of China.2.According to the influencing factors,to design the intervention programme that conformed to the local health conditions.3.To establish a web-based self-management interventions model for hypertensive patients in mountainous rural areas.4.To evaluate the efficacy of mobile management interventions model in hypertensive patients.Methods(1)The theoretical research development was reviewed and the domestic and international health management model was presented.The challenges and opportunities of hypertension management model in China was analyzed.(2)Xuanen County in Hubei Province was selected as the experimental field,and a cross-sectional survey was conducted.A total of 1207 hypertensive patients was recruited.On the basis of literature review and expert argumentation,a set of questionnaires and physical examination including the blood pressure,body weight,waist circumference,hip circumference and other health indexes of the patients,to explore the influencing factors of health-related quality of life of the patients in mountainous rural areas.(3)Clarify the theoretical and technical foundation of the construction ofhypertension mobile management platform,describe the overall framework and analysis the advantages of mobile management platform.(4)A randomized controlled trial(RCT)was carried out and the effect of web-based mobile management interventions model for 148 community hypertensive patients was evaluated through the quantitative analysis.The RCT sample were allocated to an experimental group(74 cases)and control group(74 cases).The RCT sample were satisfactory hypertensive patients from rural health service centers in Xuanen County,Hubei Province.They signed informed consents and accomplished baseline survey.The control group received usual three-level management from rural health service centers,and the intervention group received both usual management and web-based mobile self-management interventions.Results(1)In 1207 subjects,the average age was 66.57 ± 11.05 years old,of which47.56% were male and 52.44% were female.The demographic factors that influenced the hypertension compliance of patients in mountainous rural areas were: gender,marital status,source of medical expenses and years of hypertension;the factors that affected the physiological health of patients were: source of medical expenses,education level,BMI,hypertension compliance,systolic blood pressure level;the factors that affected the psychological health of patients were: gender,family monthly income,number of other chronic diseases,BMI,and hypertension compliance.(2)Intelligent blood pressure bracelet has outstanding technical advantages.In terms of detection function,the accuracy rate of intelligent blood pressure Bracelet detection results is 81.53%,and the sensitivity is 85.62%.Receiver operating characteristic curve shows that: Aug = 0.818,indicating that the intelligent blood pressure bracelet has good applicability.The mobile management platform intervention model has the following advantages: a good applicability of intelligent blood pressure bracelet,the direct participation of medical staff can improve the convenience of hypertension management,the remote electronic sphygrnomanometerwas were easy to use,promoting the effective implementation ofcomprehensive management of hypertension strategy and contributing to the advance of hypertension prevention.(3)There was no statistical difference between the demographic data of the intervention group and the control group and the index variables at baseline.After 3months of intervention,the changes of systolic blood pressure,weight and waist circumference in the intervention group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05);the changes of behavior compliance,self-efficacy and quality of life scores in the intervention group were significantly higher than those in the control group,and the differences were statistically significant(P<0.001).Conclusions1.The demographic factors that influenced the hypertension compliance of patients in mountainous rural areas were: gender,marital status,source of medical expenses and years of hypertension.The factors that affected the Health-related Quality of Life of patients were: gender,family monthly income,source of medical expenses,education level,BMI,BAI,number of other chronic diseases,and hypertension compliance.In future research,we should combine the characteristics of hypertension patients,carry out individual intervention measures to improve patients' behavior compliance,and then promote the quality of life.2.The mobile management platform intervention model can reduce the level of systolic blood pressure,reduce weight and waist circumference,improve hypertension compliance,enhance self-efficacy and improve the quality of life of patients.3.Compared to the traditional three-level management from rural health service centers,the mobile management platform intervention model can overcome the time and space barriers,optimize the allocation of medical services,and improve the effectiveness of self-management of hypertensive patients in mountainous rural areas.The internet-based mobile management has a good prospect.This study established a internet-based mobile management model in mountainous rural areas,and a series of complete intervention protocol was conductedfor this model.Based on the findings,the evidence-based suggestions were put forward to strengthen the hypertension management in mountainous rural areas. |
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