Establishment And Evaluation Of Internet-based Self-management Intervention Model Of Community Hypertension

ObjectiveTo establish and evaluate the internet-based self-management intervention model of community hypertension,to explore the new model of chronic disease management service under the background of new Internet media,and to further improve the prevention and control effect of chronic diseases.MethodsWe first set up team,combined with "chronic disease self-management practice" and other guidelines or works.The new self-management intervention model will be established that it is the internet as a medium,self-management intervention system as a platform,We Chat as monitoring platform,sports watch and intelligent electronic sphygmomanometer as monitoring tools.This program was designed which was completely independent,developed by Guangdong Fu lai Health Technology Company.In this study,106 hypertensives were recruited.There were 53 patients in the experimental group and the control group.The experimental group received the internet-based self-management intervention model of community hypertension,and the control group received routine self-management intervention model.Intervention time is 6 months.Baseline survey was conducted on the two groups before the intervention,including sex,age,marital status,educational level,medication status,genetic history and so on.The evaluation indexes were measured before and after the intervention,including blood pressure,body fitness,physical activity,diet,psychological,biochemical indicators,self-efficacy and disease awareness and other content.The evaluation of diet was conducted using a 3-day,24-hour dietary review and a family recipe registration.Psychology and self-efficacy were assessed using the Quality of Life Scale,the Depression Scale,the Anxiety Scale,the Hasegawa Simple Assessment Form,the Self-efficacy Scale.Data collection and analysis: SPSS 21.0 software was used to analyze the data and the statistical analysis.The effect of quantitative and qualitative analysis was used to evaluate the self-management intervention model of internet-based.Rusults 1.Internet-based self-management intervention model of community hypertensionIn this study,we use the self-developed "Internet +" community self-management platform for hypertension to establish the self-management intervention model of hypertension that it is a community-based,internet as medium,intelligent wearable device as a monitoring tool,patient-centered,individuation as intervention.The new model is mainly composed of doctor decision-making system,personalized intervention decision-making system and mobile phone application system system.Medical staff is monitoring the patient's blood pressure,heart rate,diet,exercise,psychological,symptoms and other content by the platform,and provide personalized guidance and accurate support for patients,and push personalized health assessment report,personalized diet prescription,personalized exercise prescription and so on.During the period,medical staff and patients continue to exchange feedback,modify goals and plans,until you find suitable for their own personalized intervention.2.Comparison of intervention effect between two groups of hypertension patients before and after intervention(1)Changes in blood pressure,control rate,and medication rate before and after intervention The systolic blood pressure of the experimental group was 5.8 mm Hg lower than that before(p <0.05).The systolic blood pressure of the control group was 2.9 mm Hg lower before,the difference was not statistically significant(p> 0.05).There was no significant difference in diastolic blood pressure,control rate and medication rate between the experimental group and the control group(p> 0.05).There was no significant difference in the systolic blood pressure difference,diastolic blood pressure difference,control rate and medication rate between the experimental group and the control group(p> 0.05).(2)Changes in biochemical indexes before and after interventionThe erythrocyte difference,serum creatinine difference,difference of serum potassium concentration,homocysteine difference,serum low density lipoprotein cholesterol difference and serum high density lipoprotein cholesterol difference of the experimental group before and after intervention were compared with those of control group.The differences were statistically significant(p <0.05).Compared with the control group,the erythrocytes and erythrocytes in the experimental group were significantly improved(p <0.05).The levels of albumin,homocysteine,serum potassium,serum sodium and serum high density lipoprotein cholesterol in the control group were significantly different from those before intervention(p <0.05)..There were no significant differences in the other biochemical indexes between the two groups before and after the intervention(p> 0.05).(3)Changes in physical fitness,physical activity,behavioral changes,waist circumference,and BMI before and after interventionThe difference before and after intervention of lung capacity,choice reaction time,physical activity,waist circumference in the experimental group were compared with those of the control group(p <0.05).In the experimental group,the difference of physical activity,vital capacity,selective response,physical activity,behavioral changes,waist circumference were statistically significant than before.TIn the controll group,the difference of one-leg standing with eye-closed was statistically significant than before.There were no significant differences in the BMI difference,grip strength difference,flexion differenc,the sitting position and one-leg standing with eye-closed difference between two groups(p> 0.05).(4)Changes in dietary before and after interventionThe valley potato difference,fruit difference,calcium difference and iodine difference in the experimental group were better than those of the control group(-91.2g,38.4g,181.7mg,0.3mg)(P <0.05).There were significant differences in the actual intake of vegetable,potato,livestock and poultry aquatic products,salt,cholesterol,calcium,potassium and iodine in the experimental group before and after intervention(p <0.05).There was no significant difference in the actual intake of food and nutrients between the control groups before and after the intervention(p> 0.05).There were no significant differences in the difference of the actual intake of food,energy and nutrients between the experimental group and the control group(p> 0.05).(5)Changes in the quality of life,depression,anxiety and cognitive function before and after the interventionThe difference before and after intervention of dynamic,social function,mental intelligence,mental health,anxiety,cognitive function in two group were statistically significant(p <0.05).In the experimental group,the scores of physical pain and affective function were significantly lower than those before intervention(p <0.05),and the scores of anxiety and depression were significantly lower than those before intervention(P <0.05).There was no significant difference in the scores of quality of life,depression,anxiety and cognitive function before and after intervention in the control group(p> 0.05).(6)Changes in self-efficacy and awareness before and after interventionThe difference of self-efficacy and awareness were significant difference between the experimental group and the control group(p <0.05).In the experimental group,the awareness,symptom management and general disease management were higher than those before intervention(p <0.05).There was no statistically significant difference in awareness,symptom management,general disease management before and after intervention in the control group(p >0.05).3.Qualitative research: Doctors believe that internet-based self-management intervention model of community hypertension can be closer to the doctor-patient distance,improve the quality of health services and efficiency of doctors.Hypertensive patients satisfied that they can solve their actual health problems.Conclusion This study found that the internet-based self-management intervention model of community hypertension had better intervention effect than conventional self-management intervention model in terms of blood pressure,physical fitness,physical activity,behavioral changes,dietary,biochemical,psychological and awareness and self-efficacy,and has real-time,participatory,personalize,popularity and so on.Therefore,this model is a viable new prevention for control of chronic diseases.