基于远程Teach-back法的老年骨质疏松精准化管理  

Precise management of the elderly patients with osteoporosis based on remote Teach-back education

作　　者：刘思佳[1,2] 朱传美 黄石书 刘立岷[4] 梁邱[1] 马秀清 何成奇[1,2] LIU Sijia;ZHU Chuanmei;HUANG Shishu;LIU Limin;LIANG Qiu;MA Xiuqing;HE Chengqi(Rehabilitation Medicine Center,West China Hospital / School of Rehabilitation Sciences,West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Rehabilitation Medicine Key Laboratory of Sichuan Province,Chengdu,Sichuan 610041,P.R.China;Outpatient Department,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Orthopedics,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Wenjiang District General Office,West China Hospital,Sichuan University,Chengdu,Sichuan 611135,P.R.China)

机构地区：[1]四川大学华西医院康复医学中心/华西临床医学院康复医学院,成都610041 [2]康复医学四川省重点实验室,成都610041 [3]四川大学华西医院门诊部,成都610041 [4]四川大学华西医院骨科,成都610041 [5]四川大学华西医院温江院区综合办公室,成都611135

出　　处：《华西医学》2018年第10期1267-1271,共5页West China Medical Journal

基　　金：国家自然科学基金(81372110);四川省科技厅支撑项目(2015SZ0054);四川省干部保健科研课题(GB2017003)

摘　　要：目的探讨远程Teach-back法对老年骨质疏松症(osteoporosis,OP)患者精准化管理的应用效果。方法 2016年6月—9月选择老年OP门诊患者,并随机分为2组:常规治疗组与远程Teach-back综合治疗组。远程Teach-back综合治疗组即在常规治疗基础上加上移动互联网(微信)对患者进行远程OP治疗管理指导。比较两组患者在治疗12个月后的OP知识、OP自我效能、日常生活活动(activities of daily living,ADL)能力、骨密度值等指标。结果共纳入老年男性患者80例,每组各40例。远程Teach-back法综合治疗组患者在运动知识、钙知识、运动效能、ADL能力及骨密度值方面的改善情况优于常规治疗组(P<0.05)。其中,远程Teachback综合治疗组和常规治疗组的运动知识干预后改善值[均以中位数(下四分位数,上四分位数)表示]分别为1.870(1.098,2.870)分和0.670(0.043,1.283)分,钙知识干预后改善值分别为2.495(1.860,3.455)分和0.250(–0.810,0.705)分,运动效能干预后改善值分别为15.015(10.490,26.175)分和6.045(1.405,13.545)分,ADL能力改善值分别为13.565(4.053,23.768)分和2.245(–4.953,7.872)分,腰1-腰4骨密度值的改善值分别为0.155(0.010,0.313)g/cm2和0.045(–0.095,0.160)g/cm2,髋部骨密度值的改善值分别为0.130(–0.023,0.245)g/cm2和0.035(–0.043,0.165)g/cm2。而OP危险因素知识和摄钙效能在两种干预方式的改善差别无统计学意义(P>0.05)。结论远程Teach-back在线教育使OP管理更有疗效。应依托康复教育和康复训练的特色,建立优势化管理模式,以预防OP和脆性骨折的发生,提高患者生活质量。Objective To investigate the application effect of remote Teach-back method on the precise management of elderly patients with osteoporosis （OP）. Methods From June to September 2016, the elderly outpatients with OP were selected and randomly divided into the conventional treatment group and the remote Teach-back comprehensive treatment group. The remote Teach-back comprehensive treatment group was given the mobile Internet （WeChat） on the basis of conventional treatment to guide patients with remote OP treatment. The OP knowledge, OP self-efficacy, activities of daily living （ADL）, bone mineral density （BMD） and other indicators were compared between the two groups after 12 months of treatment. Results A total of 80 elderly patients with OP were included, with 40 patients in each group. The comparison of the improvement values of the two groups showed that the remote Teach-back comprehensive treatment group was superior to the conventional treatment group in terms of exercise knowledge, calcium knowledge, exercise performance, ADL and BMD （P〈0.05）. Among them, the improvement in exercise knowledge intervention in the remote Teach-back group and the conventional treatment group were 1.870 （1.098, 2.870） and 0.670 （0.043, 1.283）; the improvement values of calcium knowledge intervention in the two groups were 2.495 （1.860, 3.455） and 0.250 （–0.810, 0.705）; the improvement values after exercise intervention in the two groups were 15.015 （10.490, 26.175） and 6.045 （1.405, 13.545）; the improvement of ADL in the two groups were 13.565 （4.053, 23.768） and 2.245 （–4.953, 7.872）; the improvement of lumbar 1-waist 4 BMD in the two groups were 0.155 （0.010, 0.313） g/cm2 and 0.045 （–0.095, 0.160） g/cm2; the hip BMD improvement values of the two groups were 0.130 （–0.023, 0.245） g/cm2 and 0.035 （–0.043, 0.165） g/cm2. There was no significant difference in OP knowledge between the two groups （P〉0.05）. Conclusions Remote Teach-back online educa

关 键 词：远程教育 Teach-back 老年骨质疏松 精准化管理 

分 类 号：R580[医药卫生—内分泌]