Application Of "Hospital-community-family" Trinity Health Management Model In Gout Patients Under The Background Of "Internet +"

Objective:To explore the feasibility and application effect of hospital-community-family gout and health education model in gout patients under the background of “Internet+”.Methods:(1)Establish a hospital-community-family three-level health education group to determine the division of labor,functional orientation and management methods among different levels,in conjunction with the 2016 China Gout Guide and the 2016 European League Against Rheumatism(EULAR)Recommendations for gout treatment Develop a three-level health education program for gout.Construct a hospital-community-family three-level health education model under the background of “Internet+”.(2)From April 2018 to December 2018,choose a rheumatology clinic in a third-grade hospital in Shanxi Province and a gout patient who has been managed in the community health service center of Pingyang Road,Taiyuan City.120 cases of gout patients included in the exclusion criteria were grouped by random number table method,in which odd-numbered patients were included in the experimental group,and even-numbered patients were included in the control group.The patients in the experimental group adopted the hospital-community-family three-level health education model under the background of “Internet+”.The control group received routine care.Intervention for 3 months.(3)Data collection was performed before and after patient intervention using the General Information Questionnaire for Gout Patients,the Self-Management Compliance Scale for Gout Patients,and the ideal uric acid level and uric acid level.(4)Data analysis was performed using SPSS 25.0 statistical software,and the data were analyzed by descriptive analysis,chi-square test,two independent sample t-test,and paired t-test.Results:(1)General information on gout patients:120 gout patients enrolled in the study,96 were male(80%)and 24 were female(20%),with an average age of(44.32 ± 11.41)years;the mean duration of disease was(3.88 ± 1.87)years.There were 60 gout patients in the experimental group,47 males and13 females.The average age(43.40±11.27)years old,the minimum age was 20 years old,the maximum age was 64 years;the average duration of disease was(3.80±1.59)years;the control group had 60 gout patients,including 49 males and 11 females.The average age was(45.23±11.57)years old,the minimum age was 21 years,and the maximum age was 73 years.The average duration of disease was(3.97±2.12)years.After analysis,there was no statistical difference in gender composition,age,and education level between the two groups.Significance(P>0.05).The two groups of patients are comparable.(2)Uric acid levels and idealized levels of uric acid in patients with gout:Before the intervention,the experimental group had uric acid level(504.16±101.82)?mol/L,and the uric acid level was idealized by 6(10%).The control group had uric acid level(476.99±86.28)?mol/L,and the uric acid level was ideal.There were 5 patients(8.3%).There was no significant difference in uric acid level and uric acid idealization level between the two groups(P>0.05).After the intervention,the uric acid level in the experimental group decreased to(334.78±58.59)?mol/L,and the uric acid level in the control group was 49(81.7%).The uric acid level in the control group of gout decreased to(424.71±72.48).At ?mol/L,there were 10 patients(17.5%)who were ideal for uric acid levels.After intervention,there was a significant difference in uric acid level and idealized uric acid level between the experimental group and the control group(P<0.01).After 3 months,the uric acid levels of the two groups of gout patients were statistically significant before and after the intervention(P<0.01).The ideal level of uric acid in patients with gout in the experimental group was statistically significant before and after intervention(P<0.01).The ideal level of uric acid in the control group was not statistically significant before and after intervention(P>0.05).(3)Patient self-management behavior compliance statusBefore the intervention,there was no statistically significant difference in the self-management behavior compliance,rational diet,regular exercise,compliance with medical drugs,uric acid self-test,and active medical treatment between the experimental group and the control group(P>0.05).;After the intervention,the self-administration behavior of the experimental group and the control group had a significant difference in self-management behavior,reasonable diet,regular exercise,compliance with medical drugs,uric acid self-test,and active medical treatment before and after intervention(P<0.01).Three months later,the experimental group and the control group of gout patients had significant differences in self-management behavior compliance,regular exercise,compliance with medical drugs,and uric acid self-test(P<0.01);There was no significant difference in active medical treatment(P>0.05).Conclusion:In the context of “Internet +”,the hospital-community-family three and health education model applied to gout patients can reduce the uric acid level of gout patients,promote the ideal level of uric acid control,and enhance the self-management behavior compliance of gout patients,thereby enhancing the patient self.The ability and confidence of disease management.