“互联网+”程序化随访方案在肾移植受者中的管理研究

杨娇弟; 宋君; 朱茜; 叶青; 吴存造

doi:10.16766/j.cnki.issn.1674-4152.002552

“互联网+”程序化随访方案在肾移植受者中的管理研究

doi: 10.16766/j.cnki.issn.1674-4152.002552

温州医科大学附属第一医院移植科，浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2020RC082

温州市科技计划项目 Y2020374

详细信息

通讯作者:
杨娇弟, E-mail：yjd25898@126.com

中图分类号: R197.323.2 R692
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-11
- 网络出版日期: 2022-09-23

Management of "Internet plus" procedural follow-up program in renal transplant recipients

Department of Transplantation, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨将“互联网+”与程序化随访方案以手机APP微信端为载体进行深度融合，对肾移植受者实施专业化、规范化、持久化、个性化及程序化的随访管理所取得的临床效果。方法选取温州医科大学附属第一医院移植中心行首次肾移植成功的79例肾移植受者为研究对象，按入院时间先后顺序，将2019年1—12月采用常规随访方式管理的40例肾移植受者作为常规组；将2020年1—12月实施“互联网+”程序化随访方案管理的39例肾移植受者作为干预组。对2组肾移植受者干预前后自我管理能力及生活质量评分进行对比分析。结果干预后干预组肾移植受者饮食管理、躯体活动管理、治疗管理及社会心理管理4个维度自我管理能力总评分[(106.58±17.73)分]与常规组[(83.77±14.70)分]比较，差异有统计学意义(t=6.232，P＜0.001)；干预后干预组肾移植受者生理功能、心理职能、社会功能、疾病治疗等生活质量总评分[(150.77±14.50)分]与常规组[(130.26±12.72)分]比较，差异有统计学意义(t=6.688，P＜0.001)。结论将“互联网+”与程序化随访方案以手机APP微信端为载体进行深度融合，对肾移植受者实施专业化、规范化、持久化、个性化及程序化的随访管理，能够有效提升肾移植受者的自我管理能力及生活质量。
- 互联网+ /
- 程序化随访方案 /
- 肾移植受者 /
- 自我管理能力 /
- 生活质量
Abstract: Objective To explore the clinical effect of "Internet plus" procedural follow-up program in mobile phone APP WeChat terminal for deep integration, and to achieve the professional, standardized, durable, personalized and programmed follow-up management for renal transplant recipients. Methods According to the order of admission time, 79 renal transplant recipients who successfully underwent first kidney transplantation in our hospital were selected as the research objects. Forty renal transplant recipients who received routine follow-up from January to December 2019 were selected as the routine group, whereas 39 renal transplant recipients who were followed up by the "Internet plus" procedural follow-up program from January to December 2020 were selected as the intervention group. The self-management ability and quality of life scores of both groups before and after intervention were compared and analysed. Results After the intervention, the total score of self-management ability in the four dimensions of diet management, physical activity management, treatment management and social psychological management in the intervention group was (106.58±17.73) points, and that in the routine group was (83.77±14.70) points. The difference was statistically significant (t=6.232, P < 0.001). After the intervention, the total score of physiological function, psychological function, social function and disease treatment of renal transplant recipients in the intervention group was (150.77±14.50) points, and that in the routine group was (130.26±12.72) points, the difference was statistically significant (t=6.688, P < 0.001). Conclusion The "Internet plus" procedural follow-up program are deeply integrated with the WeChat APP as the carrier, professional, standardised, lasting, personalised and procedural follow-up management was implemented for renal transplant recipients. They can effectively improve the self-management ability and quality of life of renal transplant recipients.
- Internet plus /
- Procedural follow-up program /
- Transplant recipients /
- Self-management ability /
- Quality of life

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图 1 “互联网+”程序化随访方案的管理流程

Figure 1. Management process of "Internet +" programmed follow-up plan

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表 1 2组肾移植受者自我管理能力评分比较(x±s，分)

Table 1. Comparison of self-management ability scores between two groups of renal transplant recipients (x±s, points)

组别	例数	饮食管理		躯体活动管理		治疗管理		社会心理管理		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
干预组	39	20.86±3.57	26.45±4.36	21.74±3.67	27.96±4.83	18.57±3.12	25.78±4.28	16.49±2.86	26.39±4.26	77.66±13.22	106.58±17.73
常规组	40	21.72±3.49	22.56±3.62	20.92±3.58	21.86±3.61	19.13±3.48	20.63±3.41	17.37±3.24	18.72±4.06	79.14±13.79	83.77±14.70
t值		1.083	4.319	1.005	6.346	0.752	5.923	1.279	8.193	0.487	6.232
P值		0.282	＜0.001	0.318	＜0.001	0.454	＜0.001	0.205	＜0.001	0.628	＜0.001

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表 2 2组肾移植受者生活质量评分比较(x±s，分)

Table 2. Comparison of life quality scores between two groups of renal transplant recipients (x±s, points)

组别	例数	生理功能		心理职能		社会功能		疾病治疗		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
干预组	39	28.92±2.85	36.78±3.83	21.94±2.17	27.96±2.76	41.29±3.96	48.74±4.16	31.26±3.69	37.29±3.75	123.41±12.67	150.77±14.50
常规组	40	27.98±2.76	29.38±2.84	22.75±2.26	23.59±2.67	42.17±3.83	44.18±3.98	32.17±3.72	33.11±3.23	125.07±12.57	130.26±12.72
t值		1.489	9.735	1.624	7.153	1.004	4.979	1.091	5.313	0.585	6.688
P值		0.141	＜0.001	0.108	＜0.001	0.318	＜0.001	0.279	＜0.001	0.560	＜0.001

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参考文献(15)

[1]	李笑天, 沈文. 砥砺奋进: 肾移植功能MRI的现状与展望[J]. 实用器官移植电子杂志, 2020, 8(5): 333-336. doi: 10.3969/j.issn.2095-5332.2020.05.002 LI X T, SHEN W. Forge ahead: Status and Prospect of functional MRI in renal transplantation[J]. Practical Journal of Organ Transplantation(Electronic Version), 2020, 8(5): 333-336. doi: 10.3969/j.issn.2095-5332.2020.05.002
[2]	张华, 罗燕, 温月, 等. 肾移植病人术后心理痛苦现状及影响因素分析[J]. 护理研究, 2018, 32(14): 2321-2324. doi: 10.12102/j.issn.1009-6493.2018.14.052 ZHANG H, LUO Y, WEN Y, et al. Analysis of status quo and influencing factors of psychological pain after kidney transplantation[J]. Chinese Nursing Research, 2018, 32(14): 2321-2324. doi: 10.12102/j.issn.1009-6493.2018.14.052
[3]	付迎欣. 肾移植术后随访规范(2019版)[J]. 器官移植, 2019, 10(6): 667-671. doi: 10.3969/j.issn.1674-7445.2019.06.006 FU Y X. Specifications for follow-up after renal transplantation (2019 version)[J]. Organ Transplantation, 2019, 10(6): 667-671. doi: 10.3969/j.issn.1674-7445.2019.06.006
[4]	韩健乐, 王长安, 刘金瑞. 肾移植随访质量规范化建设要点分析[J]. 实用器官移植电子杂志, 2020, 8(2): 151-153. https://www.cnki.com.cn/Article/CJFDTOTAL-YZQG202002020.htm HAN J L, WANG C A, LIU J R. Analysis on the key points of standardization of follow-up quality of renal transplantation[J]. Practical Journal of Organ Transplantation(Electronic Version), 2020, 8(2): 151-153. https://www.cnki.com.cn/Article/CJFDTOTAL-YZQG202002020.htm
[5]	丁飙, 许燕玲, 彭易, 等. 首次行经皮冠状动脉支架植入术后患者自我管理能力现状及影响因素的调查[J]. 中华现代护理杂志, 2015, 21(16): 1867-1871. doi: 10.3760/cma.j.issn.1674-2907.2015.16.003 DING B, XU Y L, PENG Y, et al. Investigation of current self-management ability and influencing factors for patients with the first percutaneous coronary artery stent implementation[J]. Chinese Journal of Modern Nursing, 2015, 21(16): 1867-1871. doi: 10.3760/cma.j.issn.1674-2907.2015.16.003
[6]	陈桂英. 当护理邂逅"互联网+"会擦出怎样的火花: 访首都医科大学护理学院院长吴瑛[J]. 中国护理管理, 2016, 16(3): 289-291. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL201603002.htm CHEN G Y. What sparks will be generated when nursing encounters "Internet +": an interview with Capital Medical Wu Ying, Dean of College of nursing, University[J]. Chinese Nursing Management, 2016, 16(3): 289-291. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL201603002.htm
[7]	庄桂敏, 阎成美, 陶小琴, 等. 肾移植受者自我管理量表的开发研究[J]. 护理研究, 2009, 23(12): 1111-1113. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ200912054.htm ZHUANG G M, YAN C M, TAO X Q, et al. Development and the reliability and validity test of self-management scale for renal transplant recipients[J]. Chinese Nursing Research, 2009, 23(12): 1111-1113. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ200912054.htm
[8]	张作记. 行为医学量表手册[M]. 北京: 中华医学电子音像出版社, 2005: 153-154. ZHANG Z J. Handbook of behavioral medicine scale[M]. Bei Jing: Chinese medical electronic Audiovisual Publishing House, 2005: 153-154.
[9]	李晓静. 延续性护理对肾移植出院患者生活质量和自我管理的影响[J]. 护理实践与研究, 2017, 14(14): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201714026.htm LI X J. Effect of continuous nursing on quality of life and self-management of discharged patients after renal transplantation ring[J]. Nursing Practice and Research, 2017, 14(14): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201714026.htm
[10]	谢红燕, 应莉, 崔英. 基于"互联网+"院外管理对台州地区高血压脑病患者血压变异性的影响[J]. 中华全科医学, 2020, 18(7): 1227-1229, 1244. doi: 10.16766/j.cnki.issn.1674-4152.001471 XIE H Y, YING L, CUI Y. Effect of "Internet +" management on blood pressure variability of hypertensive encephalopathy in Taizhou[J]. Chinese Journal of General Practice, 2020, 18(7): 1227-1229, 1244. doi: 10.16766/j.cnki.issn.1674-4152.001471
[11]	郭辉, 沙丽艳, 蒲丛珊, 等. "互联网+"应用于术后患者延续性护理的研究进展[J]. 中国护理管理, 2019, 19(7): 1045-1049. doi: 10.3969/j.issn.1672-1756.2019.07.018 GUO H, SHA L Y, PU C S, et al. Application of "internet+" to continuous nursing of patients after surgery: A literature review[J]. Chinese Nursing Management, 2019, 19(7): 1045-1049. doi: 10.3969/j.issn.1672-1756.2019.07.018
[12]	郭雪洁, 刘红霞, 韩梦汐, 等. 肾移植受者疾病不确定感现状及其与应对方式的相关性研究[J]. 中华全科医学, 2021, 19(5): 863-866, 886. doi: 10.16766/j.cnki.issn.1674-4152.001936 GUO X J, LIU H X, HAN M X, et al. Status quo of uncertainty in illness and its correlation with coping in kidney transplant recipients[J]. Chinese Journal of General Practice, 2021, 19(5): 863-866, 886. doi: 10.16766/j.cnki.issn.1674-4152.001936
[13]	韦靖, 何静, 梁芳, 等. "互联网+"在我国延续性护理中的研究进展[J]. 海南医学, 2021, 32(4): 519-521. doi: 10.3969/j.issn.1003-6350.2021.04.030 WEI J, HE J, LIANG F, et al. Application progress on"Internet+"continuous nursing in China[J]. Hainan Medicine Journal, 2021, 32(4): 519-521. doi: 10.3969/j.issn.1003-6350.2021.04.030
[14]	周志衡, 黄志杰, 郑晓芬, 等. "互联网+"糖尿病三方共管健康管理模式构建与应用研究[J]. 中华全科医学, 2020, 18(10): 1707-1710. doi: 10.16766/j.cnki.issn.1674-4152.001599 ZHOU Z H, HUANG Z J, ZHENG X F, et al. Construction and application of internet-based combining with patient-family-general practitioner group co-management model for diabetes[J]. Chinese Journal of General Practice, 2020, 18(10): 1707-1710. doi: 10.16766/j.cnki.issn.1674-4152.001599
[15]	薛冬, 何小舟, 朱枫, 等. 基于互联网的肾移植患者精细化管理模式构建思考[J]. 中国现代医生, 2019, 57(13): 134-137, 141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201913037.htm XUE D, HE X Z, ZHU F, et al. Thoughts on the construction of refined management mode of kidney transplantation patients based on Internet[J]. China Modern Doctor, 2019, 57(13): 134-137, 141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201913037.htm