The Research Of Mobile Health D2C Model In The Management Of Chronic Disease In The Grassroots Community

Objective:To compare the application of mobile health D2 C model in the management of chronic non communicable diseases in grassroots community,based on the related indexes of chronic disease management,awareness of relevant knowledge,standardized management,self-management behavior and the effectiveness of the study to evaluate the management effect of mobile health D2 C model in the grassroots community common chronic disease management,and to analyze the factors.Obtained the corresponding theoretical guidance and reference,in order to strengthen the effective management of common chronic diseases in the community and promote the transformation of the management mode,to promote the“six in one” system of community medical health service network continues to improve,and ultimately improve the level of comprehensive management of the diagnosis,treatment and prevention of chronic diseases.Methods:1.Acquirement of data: This study is based on the basic community for a randomized controlled triall,the main object of study were examined and treated area residents in Health Road Community Health Service Center,Jingkou District,Zhenjiang City of Jiangsu Province from January to December 2014.First,conducted the baseline survey.The survey includes the basic information of the individual,the status of health self-evaluation,the knowledge about chronic diseases and so on.After completing the baseline survey,the participants were randomly divided into the observation group and the control group according to the voluntary principle.Among them,the observation group was treated with the mobile health D2 C mode,and the control group was managed by the traditional management mode.Management period of 18 months,after 18 months of completion of the management,conducted the questionnaire survey for the second time.2.Design of questionnaire: Refered to the relevant literature and consulted the relevant experts,and developed chronic disease related research projects.Then to compile “Personal health information and self health assessment questionnaire”,themain contents include receiving basic personal information,investigation of their health status,self behavior management,utilization of health services and related knowledge about chronic disease related knowledge,etc.3.Correlation analysis of influence factors: The related data were statistically analyzed by SPSS 18 statistical software.And to use chi square test,descriptive analysis and other statistical methods to analyze and compare the management situation of the community health service institutions in two kinds of management modes to the common chronic diseases.Results:1.At the end of the application of mobile health D2 C mode of management of hypertensive patients SBP,DBP and BMI were significantly lower than the level at the end of the traditional way of management group,the difference was statistically significant(P<0.05);The awareness rate of hypertensive patients in the observation group was 87.5%,75%,81.73%,67.31%,78.85%,respectively,in the normal value of hypertension,risk factors,prevention methods,concurrent diseases,medication principles and other related factors,significantly better than the traditional way of management group,the difference was statistically significant(P<0.05).2.At the end of the application of mobile health D2 C management model in diabetic patients FBG,PBG,HbA1 c and BMI were significantly lower than the level at the end of the traditional way of management group,the difference was statistically significant(P<0.05);In the observation group,the awareness rate of diabetes mellitus was 86.59%,85.37%,91.46%,71.95%,78.05%,respectively,for the normal value of blood glucose,symptoms,prevention methods,concurrent diseases and medication principles,significantly better than the traditional way of management group,the difference was statistically significant(P<0.05).3.At the end of the application of mobile health D2 C model management in patients with underlying chronic disease SBP,DBP,FBG,BMI compared to the baseline level were decreased,the difference was statistically significant(P<0.05);In the observation group,the awareness rate of the main indicators related to chronic diseases,such as normal blood pressure,blood glucose,and high risk of chronicdiseases was 80%,70.91% and 78.18%,respectively.Significantly better than the traditional management group,the difference was statistically significant(P<0.05).4.The application of mobile health D2 C model to the grassroots community hypertension,diabetes,potential chronic disease patients after 18 months of management,the effective rate of standardized management of hypertension,diabetes mellitus,potential patients with chronic diseases was 75.9%,78%,74.5%,respectively.the corresponding X2 values was 4.083,4.310,5.973,respectively.P values were less than 0.05,significantly better than the traditional way of management group,the difference was statistically significant;And the observation group of hypertension,diabetes mellitus,potential of patients with chronic diseases low salt and low-fat diet has been significantly improved,the number of participating in physical exercise increased significantly,psychological status and compliance behavior were significantly improved,the overall self management behavior is better than the traditional way of management group,the difference was statistically significant(P<0.05).Quit smoking,alcohol limit behavior in the management period of improvement is not very obvious,P>0.05.5.To investigate the effectiveness of mobile health D2 C model management in patients with hypertension,diabetes mellitus and potential chronic diseases in the observation group.There were 29.6% of patients considered that the management of mobile health D2 C model is very effective,52.7% of the patients considered effective,and 10.5% of the patients thought the effect was general,only 7.2% of the patients showed invalid.6.In this study,completed the baseline questionnaire in patients with chronic disease,hypertension patients in the observation group had 106 cases,106 cases in the control group;the number of patients with diabetes in the observation group of 85 cases,the control group of 85 cases;the number of patients with high risk of chronic disease in the observation group was 59,the control group of 59 cases.For a period of 18 months of management,once again visited the data shown that the number of patients with hypertension management group 104 cases,the control group of 91 cases,the rate of loss of follow-up was 1.89% and 14.15%;the number of patients in thediabetes management group of 82 cases,the control group of 73 cases,the missed follow-up rate was 3.53%,14.12%;the number of patients with high risk of chronic disease was 55 in the observation group,49 cases in the control group,and the rate of loss of follow-up was 6.78% and 16.95%,respectively.Conclusion:1.The D2 C model of mobile health has achieved remarkable results in the management of chronic diseases in the grassroots community,such as hypertension,diabetes,and high risk group of chronic diseases.2.The application of mobile health D2 C model in the management of common chronic diseases in the grassroots community has improved the ability of health related knowledge,attitudes,behaviors of patients with chronic diseases in the grassroots community.However,based on a number of chronic disease patients with long-term development of bad habits,coupled with the limited duration of management,the study of some patients with chronic disease smoking cessation,alcohol restriction behavior has not been significantly improved.3.The application of mobile health D2 C model in the management of common chronic diseases in the grassroots community has strengthened the standardized management of the patients with chronic diseases in the community,and has been widely recognized by the majority of patients.