| Objectives:To explore the intervention effect of continuous nursing service model based on WeChat platform on discharged depression patients.By evaluating the health status,clinical symptoms,medication compliance,social support,number of visits,number of readmissions and other indicators of patients before and after intervention,the effects and advantages of this method in improving patients’ quality of life and reducing recurrence were discussed.Methods:In this experimental study,70 patients with depression who met the inclusion criteria after treatment and discharge from hospital during march to April 2019 were selected.According to the general information,70 patients were divided equally into two groups,one was the intervention group and the other was the control group.The two groups were balanced in gender,age,marriage,education,economic status,and symptoms of depression and anxiety at the time of discharge.Patients in the control group received routine follow-up after discharge,that is,telephone follow-up once a month,to inquire about the patient’s condition,medication on time,home life status,etc.,to the existence of health problems,health education or guidance;In addition to receiving routine hospital follow-up,patients in the intervention group received remote intervention by using the continuous nursing mode of WeChat platform.That is,the continuous nursing group was established,and members of the group used the WeChat official account(xinchang shu)to push knowledge related to diseases,health and rehabilitation guidance,and patients’ adverse symptoms self-test,etc.WeChat group(xinchangshu)is used to keep in touch with patients in real time,and health guidance is given to their existing health problems after discharge,so that discharged patients can still get continuous nursing services.The health questionnaire(SF-36),medication adherence scale(MMAS-8),social support rating scale(SSRS),depression self rating scale(SDS),self-evaluation of anxiety scale(SAS)and other assessment tools for the patient’s quality oflife,medication adherence,social support,depression and anxiety symptoms,number of reentry appointment times,assessment,to analyze the intervention group and control group patients at 3 months,6 months after discharge when the indexes statistically.Statistical analysis of variance(anova)of repeated measures was used to compare the differences between the two groups at each time point.Results:(1)The changes of SF-36 score,the quality of life score at 3 months and 6 months effect significantly between the groups(F = 57.652,P = 0.00),which in addition to physiological function dimension effect was not significant between the groups,(F = 2.03,P= 0.159),the physiological function,body pain,general health,energy,social function,emotional function,points on the dimension scores of mental health were significantly;The time effect of the total score of quality of life reached a significant level(F=91.346,P=0.00),P< 0.05,and all the sub-dimensions also reached a significant level.The interaction between intervention and time of the total score of life quality was significant(F=101.411,P=0.00),P <0.05,and all the sub-dimensions were also significant.Simple effect analysis: at 3 months,the total score of quality of life in the two groups was statistically significant compared with that in the control group,and the total score of quality of life in the intervention group was higher than that in the control group.The scores of each dimension are different.At 6 months,the scores of each dimension in the two groups were statistically significant compared with the control group(P < 0.05),and the scores of each dimension in the intervention group were higher than those in the control group.(2)The change of MMAS-8 score showed the total score of medication compliance at 3months and 6 months showed significant intervention effect(F=41.56,P=0.00),significant time effect(F=11.094,P=0.00),and significant interaction between intervention and time(F=30.259,P=0.00).Simple effect analysis: at 3 months,the score of the intervention group was(7.58±0.87),and that of the control group was(4.09±2.00).Moreover,the medication compliance score of the intervention group was higher than that of the control group.At 6months,the score of the intervention group was(7.95±0.10)and that of the control group was(5.66±1.39).Moreover,the medication compliance score of the intervention group was higher than that of the control group.(3)The changes of SSRS score,the total social support score at 3 months and 6 months had a significant effect on the inter-group effect(F=9.899,P=0.002),and the scores of subjective support,objective support and support utilization all had a significant effect on this effect.The total score of social support has a significant effect on time(F=69.817,P=0.00),and its sub-dimensions also reach a significant level.The total score of social support was significant in the interaction between intervention and time(F=69.974,P=0.00),and its sub-dimensions were also significant.By the simple effect analysis: social support score of intervention group(42.51±6.54)for 3 months,6 months(43.23±6.40),the control of social support score(36.29±6.24)for 3 months,6 months(36.57±5.73),two groups of patients at 3months and 6 months of social support score and each dimension score compared with the control group were statistically difference,P < 0.05;The total scores of social support and each dimension of the intervention group were higher than that of the control group.(4)The changes of SDS score,the total depression score at 3 months and 6 months had a significant intervention effect(F=75.968,P=0.00),the time effect was significant(F=44.242,P=0.00),P < 0.05,the interaction between intervention and time was significant(F=75.926,P=0.00),P < 0.05.The simple effect analysis showed that the depression score of the intervention group was(40.03±5.12)at the 3rd month and(32.86±4.57)at the 6th month,and that of the control group was(58.06±9.43)at the 3rd month and(51.17±8.07)at the 6th month.Moreover,the depression self-assessment scores of the intervention group were lower than those of the control group.(5)The changes of SAS score,3 months,6 months of anxiety score in the intervention effect is significant(F=37.149,P=0.00),P < 0.05,the time effect is significant(F=191.855,P=0.00),P<0.05,intervention and time interaction is significant(F=26.506,P=0.00),P < 0.05.Simple effect analysis: at 3 months,the anxiety score of the intervention group was(47.23±4.53),and that of the control group was(51.09±6.47).At 6months,the anxiety score of the intervention group was(30.26±3.89),and that of the control group was(43.60±5.65).The anxiety scores of the intervention group were lower than those of the control group.(6)The comparison of the number of revisit showed that at 3 months and 6 months,the number of revisit had a significant effect on the intervention effect(F=15.267,P=0.00),P <0.05,and the time effect was significant(F=2505.310,P=0.00),P < 0.05,and the interaction between intervention and time was significant(F=6.230,P=0.007),P < 0.05.By simple effect analysis: the number of intervention group on the appointment at 3 months(3.00±0.00),6months(5.71±0.62),number of the control group on the appointment at 3 months(2.74±0.56),for(5.17 ± 0.78)when 6 months,3 months and 6 months,the two groups on the appointment times are statistical differences,P < 0.05,and the intervention group on the appointment times greater than the control group.(7)The comparison of the number of readmissions showed that at 3 months and 6months,the number of readmissions had a significant effect on the intervention effect(F=9.568,P=0.003),P < 0.05,and the time effect was significant(F=9.070,P=0.002),P < 0.05,and the interaction between intervention and time was significant(F=9.070,P=0.002),P <0.05.Reentry through simple effect analysis: intervention group number for(0.00±0.00)at 3months,6 months for(0.00±0.00),number of reentry control for(0.37±0.77)at 3 months,6months(0.43±0.78 mm),two groups of patients at 3 months and 6 months,the number of readmissions statistical differences,P < 0.05,the intervention group the readmission of times less than the control group.Conclusion:WeChat platform as the medium of continuous nursing services to improve the treatment of depression patients compliance,to avoid depression recurrence.The quality of life,medication compliance,social support,anxiety and negative depressive emotions were significantly improved. |
