基于医联体共建微信平台的健康教育在门诊冠心病患者二级预防中的应用  

Application of health education based on a WeChat platform co-constructed by a medical consortium in the secondary prevention of outpatients with coronary heart disease

作　　者：董健[1] 陈清勇 杨彦[2] 曾娟[2] 黄旭 郑鸿露 刘婷[2] Dong Jian;Chen Qingyong;Yang Yan;Zeng Juan;Huang Xu;Zheng Honglu;Liu Ting(Outpatient Department,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院门诊部,成都610041 [2]四川大学华西医院心脏内科,成都610041

出　　处：《保健医学研究与实践》2024年第11期105-111,共7页Health Medicine Research and Practice

基　　金：四川省中央引导地方科技发展专项项目(2023ZYD0098)。

摘　　要：目的探讨基于医联体共建微信平台的健康教育在门诊冠心病患者二级预防中的应用效果,以期为制定冠心病患者的二级预防方案提供参考。方法选取2021年12月—2023年6月于四川大学华西医院门诊就诊的符合研究标准的126例冠心病患者,采用随机信封法分为对照组(n=63)和观察组(n=63)。对照组患者接受门诊常规随访与宣教,观察组患者接受基于医联体共建微信平台的健康教育,比较2组患者干预前后的服药依从性、自我管理能力、生活质量、心功能、运动耐量及心血管不良事件发生情况。结果干预前,2组患者Morisky服药依从性量表-8(MMAS-8)及冠心病自我管理行为量表(CSMS)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者MMAS-8及CSMS评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者西雅图心绞痛量表(SAQ)的躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率、治疗满意程度、疾病认知程度5个维度评分比较,差异均无统计学意义(P>0.05);干预后,2组患者SAQ量表的5个维度评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者每搏输出量(SV)、左室射血分数(LVEF)、6 min步行距离(6MWD)比较,差异均无统计学意义(P>0.05);干预后,2组患者SV、LVEF及6WMD均大于干预前,且观察组均大于对照组,差异均有统计学意义(P<0.05)。观察组患者干预期间心血管不良事件发生率为6.35%(4/63),低于对照组的19.04%(12/63),差异有统计学意义(χ^(2)=4.582,P=0.032)。结论基于医联体共建微信平台的健康教育在门诊冠心病患者二级预防中的应用效果显著,可以有效提高患者的服药依从性和自我管理能力,改善患者的生活质量、心功能和运动耐量,还能降低心脑血管不良事件的发生风险,值得在临床推广应用。Objective To explore the application effect of health education based on a WeChat platform co-constructed by a medical consortium in the secondary prevention of outpatients with coronary heart disease(CHD),aiming to provide a reference for formulating secondary prevention strategies for these patients.Methods A total of 126 CHD patients who met the study criteria and visited the outpatient department of West China Hospital,Sichuan University,from December 2021 to June 2023 were selected and randomly assigned to a control group(n=63)and an observation group(n=63)using the random envelope method.The control group received routine outpatient follow-up and education,while the observation group received health education based on a WeChat platform co-constructed by a medical consortium.The medication adherence,self-management ability,quality of life,cardiac function,exercise tolerance,and incidence of adverse cardiovascular events were compared between the two groups before and after the intervention.Results Before intervention,no significant differences were noted in the Morisky Medication Adherence Scale-8(MMAS-8)and Coronary Heart Disease Self-Management Scale(CSMS)scores between the two groups(P>0.05).The MMAS-8 and CSMS scores in both groups increased significantly after intervention,and the observation group had significantly higher scores than the control group(P<0.05).Before intervention,no significant differences were observed in the five dimensions of the Seattle Angina Questionnaire(SAQ)-physical limitation,angina stability,angina frequency,treatment satisfaction,and disease perception-between the two groups(P>0.05).The scores for all five dimensions of the SAQ in both groups showed a significant increase after intervention,and the observation group had significantly higher scores than the control group(P<0.05).Before intervention,no significant differences were found in stroke volume(SV),left ventricular ejection fraction(LVEF),or 6-minute walking distance(6MWD)between the two groups(P>0.05).The SV,LVEF,and

关 键 词：医联体 微信平台 冠心病 二级预防 心功能 生活质量 服药依从性 

分 类 号：R541.4[医药卫生—心血管疾病]