The Reaserch About Self-management Based On Telephone And Wehat In Patients With Systemic Lupus Erythematosus

Objectives To explore the effectivenes of self-management behavior, self-efficacy, medication compliance and disease outcome(systemic lupus erythematosus disease activity index, clinical parameters) of nursing intervention based on telephone and wechat in patients with systemic lupus erythematosus. To explore interventions to improve the health behavior of patients with systemic lupus erythematosus.Methods 1. 88 patients were selected in the Department of rheumatism of a top three hospital from October 2014 to April 2015.The patients were randomly assigned into control group(44 cases) and intervention group(44 cases) on discharge day.Patients from the control group were given routine care:health assessment, systemic lupus erythematosus treatment manual, telephone consulting and so on.Besides the routine care,the intervention group were given personalized intervention and the group intervention: analysis,planning, telephone and wechat intervention after discharge. 2. Data was collected on the discharg day and the 3rd month, the 6th month after intervention including the general questionnaire,chronic disease self-management study measures(self-management behavior scale, chronic self-efficacy scale), medication compliance questionnaires,systemic lupus erythematosus disease activity index-2000,laboratory parameters(C-reactive protein, erythrocyte sedimentation rate, complement C3, C4). 3. Data was analyzed by SPSS 17.0. Chi-square test was used in qualitative data of the general information, t-test was used in quantitative data. self-management behavior scale, chronic self-efficacy scale, systemic lupus erythematosus disease activity index-2000 were analysised by repeated measurement, laboratory parameters and medication compliance were analysised by chi-square test.Results 1.There was no significant difference in demographic data,disease-related information(P>0.05). 2.The score of physical exercise, cognitive symptom management, communicating with doctors between two groups on the day be hospitalized and the 3rd month, the 6th month after intervention show that the time effect is statistically significan(P<0.01),without considering intervention factor,the score of physical exercise, cognitive symptom management, communicating with doctors in intervention group were improved with time. The group effect is statistically significant(P<0.01). An interaction is exist in time effect and group effect(P<0.01). 3.The self-efficacy score of the two groups were analysised by repeated measurement, the time effect is statistically significan(P<0.01),without considering intervention factor,the score of self-efficacy changed with time. The group effect is statistically significant(P<0.01). An interaction is exist in time effect and group effect(P<0.01). 4.The SLEDAI-2K score of the two groups were analysised by repeated measurement, the time effect is statistically significan(P<0.01),without considering intervention factor,the score of SLEDAI-2K in intervention group changed with time. The group effect is statistically significant(P<0.01). An interaction is exist in time effect and group effect(P<0.01). 5.The erythrocyte sedimentation rate, C-reactive protein, complement C4 of the two groups were not statistically significan before the discharge day and the 3rd month after intervention(P>0.05), ESR abnormal rate, C-reactive protein, complement C4 between the two groups of patients was statistically significant at the 6rd month after intervention(P<0.05). Complement C3 between the two groups of patients was not statistically significant before the discharge day(P﹥0.05),and was statistically significant at the 3rd month and the 6rd month after intervention(P<0.05). 6. There was no statistically significant on medication adherence between two groups at discharge, and still on the 3rd month after intervention.The intervention group(52.38%) had a better medication compliance compaired with the control group(46.34%).There was statistically significant at the 6rd month after intervention(P<0.05).Conclusions The self-management behaviors, exercise time, management of cognitive symptoms, level of communication with doctors, self-efficacy, medication compliance were improved by nursing intervention based on telephone and wechat. It is suitable for promotion in clinical care.