| Objective This study intends to investigate the usage intention and service needs of diabetes selfmanagement We Chat official account through pre-surveys and interviews,combines with exploitation conditions to establish an official account that is applicable for homecared elderly patients with type 2 diabetes mellitus,completes the evaluation of its usability and validity,and applies it to improve patients' self-management knowledge,beliefs and behavior after adjustment and perfection.Methods 1.200 elderly patients with type 2 diabetes mellitus were sampled in Shanghai and Zhejiang Provincial third grade general hospitals by convenience sampling method.The patients were investigated with general data sheet,cognitive status questionnaire and Usage Intention Scale of Diabetes Mellitus We Chat Platform.The current situation of willingness to use was described and analyzed by SPSS21.0,while the single factor analysis was completed by Welch test and variance analysis.Through the path analysis of influencing factors of usage intention through AMOS 22.0,the final theoretical model is formed to guide the problem solving of patient participation.2.Using qualitative research method,20 elderly patients with type 2 diabetes mellitus were interviewed to explore their attitudes towards the use of Wechat official account and service needs,therefore providing strategic basis for the construction.3.On the basis of previous surveys and interviews,referring to the theory,through the cooperation of research team and technical team,the development technology and key points are established,the development plan is drawn up,and the preliminary construction is completed.After the discussion of the focus group meeting of the internal test results,the revised scheme was formed and further improved.Finally,the medical professionals try one-to-one and adjust according to their feedback.4.The usability of official account was evaluated by 5 patients.The validity of the study was evaluated by 16 elderly patients with type 2 diabetes mellitus using a mixed research method.The effect was evaluated by metabolic index and self-management scale.The user experience feedback was completed through patients' interviews.Results 1.In elderly patients with type 2 diabetes,83.5% of mobile phones are equipped with Wechat,52% of self-management guidance can be implemented through the Wechat platform,but only 35% of patient have used it.The total average score of willingness to use was 10.99±3.08 and the items average score was 3.66±1.03.Usage intention was positively affected by performance expectation,effort expectation and social impact(P<0.05),and negatively affected by perceived risk(P<0.05).2.Through qualitative interviews with 20 elderly patients with type 2 diabetes mellitus,three themes were derived with analyses,which corresponded to users' needs for Wechat official account design,function,help and reliance.3.In this study,three internal tests were organized for the initial construction of official account,then the corresponding modification schemes for the server and the user terminal were formed.For the revised public number,the expert trial results feedback five Suggestions.Due to the difficulty of developing health diary,it was promoted through consultation and referring to expert feedback.4.In the usability evaluation,patients accessed more actively.The average score of the four dimensions of the system usability questionnaire was>4,and the items 3,6 and 9 of the questionnaire scored<4.The number of errors in medication management was higher.In the validity evaluation,repeated one-way Anova showed that using time had influence on 2h PG and FBG(P<0.05);FBG,2h PG,Hb A1 c,body weight,body fat rate and systolic blood pressure had significant difference before and after using Wechat official account(P<0.05);and the knowledge and behavior dimensions of self-management scale had significant difference before and after use(P<0.05).Conclusions 1.The elderly patients with type 2 diabetes have a better understanding of the Wechat platform,but their practice is unsatisfactory.Most of them are willing to use Wechat for self-management.Their usage intention of Wechat is above average and influenced by four factors such as performance expectation etc.Identifying the influencing factors can help increase patient participation.2.Elderly type 2 diabetes patients have their special needs for We Chat official account.On the one hand,it is designed for the official account;on the other hand,it has functional needs,which should be included as a construction strategy.3.The usability of official account in this study is satisfactory,though partial functions still need to be optimized.In the mean while,elderly patients with type 2 diabetes still show a lack of self-confidence in using the account independently.Before and after the intervention with official account,patient blood sugar control and some physiological indicators improved significantly,PG and FBG decreased significantly over time using it,and self-management level also improved significantly.However,the effect of this Wechat public account still needs to be verified by large samples,long-term follow-up and thorough study. |
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