Evaluation Of Intervention Effect Of "Internet+Nursing Service" On Family Non-Invasive Ventilation Therapy For Patients With Overlap Syndrome

Research Purpose:To understand the compliance of family non-invasive ventilation treatment for patients with overlap syndrome and the current status of treatment effects,and to explore the 6-month intervention based on"Internet+nursing service"for family noninvasive ventilation treatment patients with overlap syndrome to observe the treatment compliance and efficacy To evaluate the overall intervention effect,in order to realize the whole-process management of family non-invasive ventilation treatment of overlap syndrome patients from hospital to family,improve patient compliance and treatment effect,evaluate cost-effectiveness,and explore the"Internet+nursing service"model for overlap The specific ways and methods of intervention for non-invasive ventilation patients with syndrome.Research Methods:This research adopts an experimental research design.From December 2019 to December2020,106 patients with overlap syndrome who were discharged from the respiratory department of a tertiary A hospital in Huzhou who met the inclusion and exclusion criteria were used as the research object,and using similar experimental research methods Divide into groups.In the hospital’s 7 urban medical community services,and selected the hospital’s"Internet+Nursing Service"information technology platform,patients with overlap syndrome family non-invasive ventilation treatment are listed as the text group(n=53).Those who have not chosen the hospital’s“Internet+nursing service”information technology platform Patients were classified as a matched group(n=53).The control group received non-invasive ventilation treatment during hospitalization and received regular care and health education,and were given discharge guidance and followed up by telephone after discharge;the intervention group was given regular nursing education and discharge guidance in addition to the control group Continuing nursing intervention based on the"Internet+Nursing Service"platform can be implemented after discharge from the hospital,and the duration of the intervention is 6 months.Patients can select the home non-invasive ventilation project section of this hospital by using the medical care visit in the Wemai app,and personalize and target the diversified needs of patients through We Chat group management,online health follow-up,and offline door-to-door service.Nursing intervention.Before the intervention,collect the general data of the patients,and collect the actual number of days using the ventilator>6h/d,blood gas analysis and pulmonary function determination,sleep breathing parameters,Epworth sleepiness score,and nursing related data at two time points before the intervention and 6 months after the intervention.Cost indicators and patient-related benefit indicators.Use SPSS26.0 statistical software to perform statistical analysis on the data.Statistical methods include:descriptive statistical analysis,?~2test,t test,and the test levelα=0.05.Research Results:1.Subjects lost to follow-up:53 cases were included in the two groups before the intervention,and 4 cases were lost to follow-up.The final total sample size was 102 cases and 51cases in each group.2.Baseline survey results:The general data and main indexes of the two groups of patients before the intervention were not statistically sense(P>0.05),and they were comparable.In general data,there are 83 males and 19 females.There are 67 cases of elementary school and below,23cases of junior high school,and 12 cases of high school and above.The average age of the intervention group was(47.20±5.52)years,and the average age of the control group was(46.84±7.00)years.Two independent sample t-tests were applied to contrast the balance between the age and BMI values of the two sets of patients.The 2-test was applied to contrast the balance between the two groups of patients’gender,living style,settlement method,and whether or not they smoked.The Mann-Whitney U test was complied to contrast the two groups.The balance among group patients’education level,average monthly income,course of disease,and lung function classification.The test showed that the discrepancy was not statistically sense(P>0.05)and was comparable.The average monthly ventilator use time for the 6 months before the intervention was>6h/d:the intervention group was(13.41±5.27),and the control group was(14.22±5.24);lung respiratory function includes PH,Pa CO2,Pa O2,FEV1 and FEV1/FVC values,sleep respiratory function includes AHI,maximum apnea time,longest hypoventilation time and minimum blood oxygen saturation value at night The value of Epworth sleepiness score was not statistically significant between the two groups(P>0.05),which was comparable.3.Intervention effect of"Internet+nursing service"on home non-invasive ventilation treatment for patients with overlap syndrome(1)Average monthly ventilator use time>6h/d days:two independent sample t-tests contrast between groups showed that the number of days after meddling in the text group(22.31±3.17)was higher than the number of days in the matched group(15.18±4.63),and the discrepancy was statistically sense(P<0.05);the average monthly ventilator use time of the intervention group before and after the intervention>6h/d days difference(8.90±5.67)is greater than the difference in the matched group(0.96±7.29),the discrepancy is statistically sense(P<0.05).(2)Lung respiratory function indicators:two independent sample t-tests compared between groups showed that the lung respiratory function indicators of the two groups had improved.After the intervention,the lung respiratory function indexes of the two groups were compared.The PH,Pa O2,FEV1,FEV1/FVC values of the text group were higher than those of the control group,and the Pa CO2 value was less than that of the control group.The differences were statistically sense(P<0.05);The difference of the lung respiratory power indexes of the two groups before and after the intervention was compared.The difference of PH,Pa O2,FEV1,FEV1/FVC of the text group was greater than the difference of the matched group,and the difference of Pa CO2 of the text group was smaller than the difference of the control group.The discrepancy between the two sets was contrast All were statistically sense(P<0.05).(3)Sleep respiratory function indicators:two independent sample t-tests were compared between groups and the results showed that all indicators of sleep respiratory function in the two groups were improved except for the Epworth sleepiness score.After the intervention,the sleep breathing function indicators of the two groups were compared.The lowest blood oxygen saturation value of the text group at night was higher than that of the matched group,and the AHI,longest apnea time,longest hypopnea time,and Epworth sleepiness score were lower than those of the matched group.It is statistically sense(P<0.05);the difference between the two groups of sleep-respiratory power indicators before and after the intervention was compared.The differences in AHI,the longest apnea time,and the longest hypoventilation time in the text group were all smaller than the difference in the matched group.The difference in minimum blood oxygen saturation at night was greater than the difference in the matched group,and the discrepancy between the two sets was statistically sense(P<0.05).However,the difference in Epworth sleepiness scores in the text group(-1.25±4.73)was smaller than the discrepancy in the matched group(-0.22±5.39),and the discrepancy was not statistically sense(P>0.05).(4)Cost-effectiveness indicators:two independent sample non-parametric tests are performed between groups.The results show that the cost-effectiveness of the text group and the matched group after the intervention,the number of nursing services and the total nursing service cost of the text group are higher than those of the matched group,and the difference is statistically sense(P<0.05);the discrepancy in the number of AECOPD and the number of hospitalizations between the two sets was not statistically sense(P>0.05).Research Conclusion:1."Internet+nursing service"can improve the compliance of family non-invasive ventilation treatment for patients with overlap syndrome.2."Internet+Nursing Services"can improve the lung respiratory function of patients with overlap syndrome,increase the PH and Pa O2 values to the normal range,and reduce the Pa CO2,FEV1,FEV1/FVC values to the normal level.3."Internet+Nursing Service"can improve the sleep breathing function of patients with overlap syndrome,increase the minimum blood oxygen saturation at night,reduce the AHI value,the longest apnea time,and the longest hypoventilation time,but it can improve daytime sleepiness Not obvious.4."Internet+nursing service"can be applied to patients with overlap syndrome family non-invasive ventilation treatment;each patient applies for nursing service an average of 1.5 times,that is,the demand for family non-invasive ventilation treatment care services for overlap syndrome patients is widespread;The cost of nursing service is at a medium level and can be accepted by patients within the economic range of patients in the region;however,"Internet+nursing service"has no significant effect on reducing the number of AECOPD and hospitalizations in the patient benefit index.