Identification And Intervene Feasibility Study On Medical Opinion Leaders In Community Chronic Disease Management From Hypertension Patients Social Network Perspective

Objectives:This study with hypertension as the breakthrough point, using opinion leader theory in the management of chronic diseases in community, to explore the feasibility of interventional medical opinion leaders and provide a new method to improve the treatment compliance of patients, promote the transformation behavior.Methods:Firstly, we designed a community medical opinion leader identification questionnaire(three dimensions, 17 entrys), including the preparation of the health management self-efficacy, health management and health management influence. Then multistage randomized cluster sampling was used to select 4 communities in Jingmen. 265 typical chronic disease Patients with hypertension as the research objects from these communities. They were investigated by questionnaire Face-to-face. Data was recorded by Epidata3.1 software. We used IBM SPSS23.0 statistical analysis software to describe medical opinion leaders’ characteristics, and compare the medical opinion leaders with the ordinary patients in demographic characteristics, personal characteristics and chronic disease network characteristics. Finally based on the identification of medical opinion leaders, combined with the analysis of Netdraw software to draw network diagram and UCINET-6 software community chronic disease community chronic disease network characteristic results,discuss the feasibility of the medical opinion leaders from the intervention of community chronic disease network structure optimization point.Results:Reliability and validity analysis showed that the three dimensions of the questionnaire Cronbach’s alpha coefficient were above 0.7; exploratory factor analysis of the dimensions of averaged a major factor and factor of variance cumulative contribution rate of more than or basic reached 70%. The questionnaire meeted the requirement of measurement. In demographic characteristics, Medical opinion leaders had significant higher level occupation(χ2=11.575,P=0.021), education(χ2=10.832,P=0.029) and economic status(χ2=9.151,P=0.010), but no differences in age and gender. In chronic disease management features, they had longer years of illness(Z=-1.120,P=0.263), lighter initial blood pressure(χ2=6.186,P=0.045<0.05).Disease knowledge score(Z=-2.053,P<0.05) and health behavior score(Z=-4.702,P<0.05) of medical opinion leaders group were significant higher than control group. In community chronic disease network, opinion leader had higher centrality degree(Z=-0.788,P<0.431). Theose resluts showed that the questionnaire can identify the medical opinion leader well. Community chronic disease network graph and network characteristic analysis results showed that the four communities chronic disease network structure density were low(0.013, 0.012, 0.017, 0.016), isolated nodes high(8.9%, 7.0% and 10.4%, 12.4%), network center potential were high excessively(35.1%, 50.0%, 28.7%, 34.7%). chronic diseases community network connectivity was not well, the structure needed to be improved, so medical opinion leaders involvetion is feasible.Conclusions:The structured questionnaire can identify medical opinion leaders in chronic disease Patients. The community chronic disease network structure has not been able to provide a good social support environment for patients with chronic diseases, medical opinion leaders can intervene the network.