Study On The Construction Of "Internet + Community" Health Management Platform For Chronic Kidney Disease

ObjectiveThis study was designed to understand the status and needs of the use of Internet health management services in patients with chronic kidney disease(CKD)and to build a module system for the "Internet + Community" health management platform for this people.The purpose was to provide comprehensive,real-time and professional community health management services for patients with CKD by relying on the medical resources of tertiary hospitals and community,and to provide reference for the future construction of Internet-based community health management model.Methods1.By purposive sampling,a self-designed questionnaire was used to investigate 134 patients with CKD who were hospitalized in three general hospitals of Nanchang city.2.On the basis of literature review,questionnaire survey and seminar,the content system of "Internet + community" health management platform module of CKD was preliminarily formulated,and the module were further revised by Delphi method.The 19 experts of the first round consulting are from the fields of nursing education,hospital management,nephrology,medical informatics and community healthcare,the second round consulted 18 experts.The experts were required to assign the importance and feasibility of the indicators at all levels,and fill out the general situation questionnaire,familiarity questionnaire and judgment basis.Amend the contents of the module after every round of consulting according to experts' feedback.Results1.The results of questionnaire(1)The utilization status: The awareness rate of Internet health management services was 63.43%,the utilization rate was 31.34%,72.39% of the patients indicated that they were willing to use the services if they had condition and ability;the main obstruction factor in the use of the services were the inability to use the Internet(44.03%),concerning about the quality(30.60%),and leading to personal privacy leak(20.90%);age,educational level and household income monthly were the influencing factors for the utilization of the services(P<0.01)(2)The demands situation: The demand rate of each project of Internet health management services is more than 50.00%;the demand rate ranked in the top 5 is regular remote health assessment and develop personalized health plan(88.81%),online appointment(88.81%),remote diet monitoring and guidance(86.57%),remote monitoring of physiological index and guidance(85.07%)and online viewing and interpreting the test results(82.84%).2.The results of Delphi methodThe positive coefficients of the two rounds of experts were 90.48% and 94.74% respectively,and the proportion of experts was 63.16% and 22.22% respectively.The degree of expert authority was 0.81;two rounds of correspondence at all levels of the importance of indicators were greater than 3.74,the feasibility score were greater than 3.58,the coefficient of variation fluctuates from 0 to 0.280,the variability coefficient fluctuates from 0.114 to 0.301,and the Kendall's harmonics fluctuates from 0.034 to 0.192,and the chi-square test is statistically significant(P<0.05).Because of the indicators need to meet the importance and feasibility of the assignment mean> 3.50 and the coefficient of variation <0.25,according to expert opinion on the indicators to filter and modify,and ultimately formed with three primary indicators,15 Secondary indicators and 62 tertiary indicators of CKD "Internet + community" health management platform module system.Conclusion1.The utilization rate of Internet health management services of patients with CKD is low,but there is a big demand for them.It is important to develop the Internet health management services for patients with CKD,and based on the characteristics of different patients to guide them use the Internet health management services.2.In this study,thet content of the "Internet + Community" health management platform is determined by expert consultation,and the expert enthusiasm is good,and they have high professional representation and authority.The expers' opinions are also more coordinated and the research results are scientific reliable.The research provides a reference for various types of chronic diseases to construct "Internet + community" health management service model.