Application Research Of Health Management Strategy Based On The Theory Of Self-Management In Outpatients With Functional Dyspepsia

Objectives. This study aimed to the outpatients with functional dyspepsia implementation of health management strategy based on the theory of the self-management. The purpose was to explore the influence of the method to the quality of life, self-efficacy, mental status and symptoms of digestive tract, to make patients at home achieve disease management, role management and emotional management. In the end, the research was to maintain happy state of life.Methods.1.Qualitative research.The research was guided by the phenomenology method of qualitative research and purposive sampling method. The samples were taken from sixteen outpatients with functional dyspepsia in the hospital of Suzhou.They were invited to participate in a semi-structured interview individually that used Colaizzi method to analysis the data. The result of qualitative research were regarded as the basis of health management strategy.2.Survey the quality of life among outpatients with functional dyspepsia and analyze its influence factors. We survey 268 cases of outpatient with functional dyspepsia who were recruited by convenience sampling using FDDQL life quality scale, functional dyspepsia self-efficacy scale,the Zung self-rating anxiety scale and depression self-rating scale to analyze the influence factors of the implementation of health management strategy to the quality of life. The results of survey were also regarded as the basis of health management strategy.3.Implementation of health management strategy. Based on the researches above and the theory of the self-management, health management strategy was formed. This study was a single blind and randomized controlled trials. We used convenience sampling method from Suzhou 3 armour hospital in outpatient department service to collect 126 cases of functional dyspepsia patients as the research objects. Using a random number table object according to the doctor order number sorting, the study was divided into the control group and intervention group. The control group was given routine outpatient service mission and telephone follow-up. The intervention group was given 6 weeks health management strategy intervention. Implementation strategy according to "163" steps( one manual given, covering disease management,role management and emotional management knowledge and skills; 6 times telephone follow-up after the treatment in the hospital, follow up door to door if necessary; Three times face-to-face teaching, emphasizing and extend more about the disease managements, role managements and emotional managements knowledge.) Use functional dyspepsia life quality scale, the self-efficacy scale, mental condition, symptom scores, health behavior and the number of visiting doctor as the main evaluation tools, observe the changes between two groups in 1 month and 3 month. Put all the data inside SPSS17.0 statistical and analysis.Results.1.Qualitative research. Understanding and exploring in outpatients with functional dyspepsia self-management after real experience, four problems were found: complex emotions in the process of self-management; lack of self-management knowledge and ability; limited professional guidance implementation; strong expectations to get care and support from family and community.2.Survey the quality of life among outpatients with functional dyspepsia and analysis its influence factors. The investigation and analysis result of 268 patients showed low quality of life in outpatient with functional dyspepsia. Mental condition especially anxiety, disease severity, course of disease, and self-efficacy would influence patients’ quality of life. 3. Implementation of health management strategy to the patient. A total of 14 subjects dropped out of 140 subjects that were recruited into this study. Results were presented on the remaining 126 subjects with 65 in the experimental group and 61 in the control group. Two group basic information balance inspection showed no statistical differences before intervention. After the intervention, the intervention group in the quality of life scores in each dimensions are higher than the control group(P <0.01), especially in the three dimension(worry, health and disease control). Self-efficacy score increased after intervention(P <0.01).Mental state scores of SAS, SDS scores significantly decreased(P<0.01),The digestive tract frequency and severity of symptom improved significantly(P<0.01). After intervention, the patients in the experimental group improved their health behavior significantly, and the number of visiting doctor reduced.Conclusions. The study shows that outpatient patients with functional dyspepsia have many problems in the process of self management. The quality of life was influenced by psychological condition, especially anxiety, disease severity, duration, and self-efficacy. The application of the health management strategy which based on the theory of the self-management and the results above can effectively improve the quality of life, self-efficacy, mental status, gastrointestinal symptoms, healthy behaviors, and reduce the number of outpatient patient visits.