| BackgroundCurrently, Diabetes poses a global exposure in the world, but the awareness rate andcontrol rate still remains low. Some complications aroused by diabetes also brings greatpain and burden for the patients and their families, thus a lot of money and effort are spenteach year on the diabetes and its complications. Yet the occurrence and development hasclose connections with the living style and self behavior management of people. Researchshows that the intervention management of the living style could improve the blood sugarcontrol in the patient, therefore the occurrence and development of complications could beminimized. In the meantime, diabetes is both a physical and psychological disease, mostof the patients suffer from such bad mental states as depression, worries and hostility,this also brings great pressure on the families of the patients and greatly affects the qualityof life of the patients and their families. Lots of research find that professionalpsychological tutoring for diabetes patients could improve the psychological cognitivestandard and positive handling behavior of the patient, eventually the treatmentsatisfaction and the quality of life were also improved. Mobile phone and Short Messaging Service (SMS) facility are widely used in the medical and health institutions, especially inthe treatment monitoring of some chronic disease and applied research of living stylechange, both had great effect. This research aims at using SMS to instruct patient, monitortreatment and give psychological tutoring to the patient of type-2diabetes, assess thecomprehensive management of effectiveness and feasibility of telephone follow-up andprovide valuable clinical evidence and reference from better applying moderncommunication methods to facilitate health conditions and medical monitoring.Objectives1、Observe the routine tutoring and daily monitoring management of diabetes patientsby SMS and assess the effect of SMS follow-up in the treatment of diabetes.2、Observethe intervention management of psychological behavior of the patient by SMS and assessthe effect of cognitive-psychological-behavior management of the diabetes patient bySMS.3、Put forward an simple, effective and feasible long-term method for control andmanagement diabetes patient which as the center in order to reduce personal and socialcosts due to diabetes.MethodsSection1、Divide100type2diabetes patients into mobile message follow-up group(50cases) and normal outpatient follow-up group(50cases).weekly communication by SMS isconducted once a week, and normal outpatient group continues12weeks once everymonth. The content of SMS is basic knowledge of diabetes and DSME proper exercise,scientific diet, regular continuation of medication, and hypoglycemia prevention andemergency treatment. Compare the changes such indicators as HbA1c, blood glucose,blood pressure,serum lipid profile and body weight. Section2、Divide120type2diabetes patient into mobile message follow-up group (60cases) and normal outpatientfollow-up group (60cases).the research doctor or the nurse contacts the patient by SMSweekly, another group once every month and continues12weeks. The content of SMS isbasic knowledge of diabetes，Meanwhile conduct questionnaire survey of the knowledgeof diabetes, psychological conditions, cognitive behavior and life satisfaction before andafter the study.Results Section1、Significant decline was showed post-treatment in hemoglobin A1C, fastingand postprandial blood glucose, blood pressure, serum lipid profile and body weight, ofwhich the changes in hemoglobin A1C, fasting and postprandial blood glucose werecomparable between SMS and routine groups (p=0.052). The changes in blood pressureand body weight were significantly higher in SMS group compared with routine group (p=0.030and0.032, respectively). Section2、 After followed up for12weeks, SMSgroup HbA1c decreased by1.9%, control group decreased by1.2%(P=0.016). Theweight of SMS group was lower than the control group (71.2Kg±6.7VS73.1Kg±7.3,P=0.030)； Diabetes knowledge， psychological conditions， ADDQoL，treatment satisfaction scores were all improved in SMS group (P<0.05); Also the increaseof exercise per week (4.6h±1.3VS3.8h±1.9，P=0.025) and reduce of smoking (8.0±4.7VS10±5.4,P=0.037) were all better than control group.ConclusionType2diabetes management by SMS is effective not only in blood glucose and HbA1cbut also in blood pressure and body weight control. The cognitive-psychological-behaviorintervention management of the diabetes patient by SMS follow-up could obviouslyimprove knowledge level, promote behavior change, enhance self-manage abilities andbehavioral strategies to cope with the negative emotion, and contribute to improve thelevel of treatment satisfaction and life-quality. This type of mobile message follow-up isdifferent from cramming method of teaching, which can make patient participate indiscussion actively and positively with a friendly and equally attitude. The patient with arelatively complete and accurate message have a better control in blood glucose andrelated index, which can also meet patient individual needs. Conduct all-inclusive andcontinuing mobile phone message follow-up for diabetes patient could improve preventionand treatment standard of diabetes patient, this mode is worth further studying andpromotion to more fields. |
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