Effectiveness And Influencing Factors Of Self-Management For Hyperuricemia In Community

ObjectiveTo explore the feasibility and acceptability of self-management module for hyperuricemia patient in community under team support from medical professionals, as well as to evaluate its efficiency and explore the proper interventional strategies for hyperuricemia patient in community.Method10 neighborhoods in Longhua Commuity, Xu Hui District were selected to execute this interventional test using cluster sampling and randomization method. All the patients with hyperuricemia from a baseline survey in these 10 neighborhoods were enrolled into this studyAn questionnaire for baseline assessment and evaluation as well as training program of self-management were developed according to the Chronic Disease Management Program as well as special need for hyperuricemia. Randomized interventional trail was employed for the study. The experiment group received the intervention of the training program of self-management for hyperuricemia. Both experiment and control groups were followed up and evaluated. In addition, focus-group interviews with some of self-management team members, team leaders and medical service providers were conducted too.Result1. Baseline:After cluster sampling and randomization, total 361 patient enrolled into this study, experiment group had 182 patients (Male:95,52.2%,Female:87,47.8%, average age:63.79±11.14), control group had 179 patients (Male:96,53.6%, Female:83,46.4%, average age:63.58±11.08). There was no significant difference between the two groups in gender, age, education background, marital status, as well as lifestyle such as smoking, drinking, food habit, physical exercise and sleeping. No significant difference for two groups was found for the awareness of hyperuricemia, self-management behavior and the treatment too. However, the control group had statistically significantly higher prevalence of diabetes than the experiment groups, (experiment group: 27 case Vs control group:46 case, P=0.018), and diastolic pressure in the experiment group was statistically significantly higher than that in the control group (experiment group:80.67±9.24 mmHg Vs control group:77.73±7.64 mmHg, P=0.008).2. Self-management activity and interview: The attendance rate in the experiment group was 92.17%. In the focus group interview, most of the patients believed that these self-management activities were helpful and effective to manage hyperuricemia. The period and frequency were reasonable and acceptable too. The self-management group leaders were capable with their job and willing to take this responsibility during the whole study period. Also, the community medical care team could provide proper support to this study.In order to improve the knowledge and awareness to hyperuricemia, two booklets of training materials named as <<Self-Management for Hyperuricemia>>and<<The Guideline for Hyperuricemia Self-Management>>were developed based on the textbooks on <<The Self-Management Guide for Hypertension>> and <<he Guidline for Hypertension Self-Management>> which edited by Prof. Fu Dongbo and Prof. Fu Hua. Some special contents were added in these booklets with focus on the description for hyperuricemia, relationship between hyperuricemia and unhealthy life style, dietary management, and the treatment by traditional Chinese medicine.3. Result after interventionAfter intervention in the experiment group, more significant improvements as followings were observed comparing with the control group:regular self-monitoring hyperuricemia; recording dietary structure; controlling smoking and alcholod, but drinking more tea; low purine diet, more rming food, drinking more water; rational and careful taking medication; which would impact the purine excretion; joint protection and caring; regular physical exercise; self-emotional control; regular monitoring blood lipoids, glucose, blood pressure and weight.also in addition, the subjective feeling for health and the ability to deal with disease were significantly better in the experiment group than the control group; For the knowledge and awareness to hyperuricemia, physical exercise and health care, medication and monitoring in theexperiment group was also superior than the control group. As to the blood biochemical indexes, the hyperuricemia level, body mass index(BMI), total cholesterol level, blood urea nitrogen were significantly improved in the experiment group(p<0.05).Conclusion:Our study found it was feasible and acceptable to promote self-management module for hyperuricemia patient in community under the support from professional medical service team. The patients’ awareness level, ability to self-management, the subjective feeling for health and blood biochemical indexes were significantly improved. It indicates that self-management are efficiency in the community.