| RICE is an acronym for Reason,Ideas,Concerns and Expectations.RICE consultation is a human-oriented approach with general practice characteristics,and general practitioners can better evaluate the psychosocial factors that may lead to patients’ physical discomfort and provide patients with psychological counseling by using this consultation mode.Health prescription refers to the methods other than drugs that can promote the health of patients,such as knowledge of diseases and health,healthy behaviors to be adopted,etc.,aimed at promoting patients to develop a healthy lifestyle.With the increase of social pressure,the weight of psychological and behavioral lifestyle in influencing human health is increasing,and it has become the dominant factor affecting the occurrence,development and outcome of diseases.Patient enablement(PE)refers to the confidence and ability of patients to deal with their own health problems.It is based on the core concept of general practice,that is,patient-centered,and puts more emphasis on letting patients participate in the management of their health problems.Self-management refers to the use of self-regulation skills to manage diseases or risk factors for these diseases.Previous studies have shown that good PE and self-management will be conducive to clinical improvement of the disease.Hypertension is a common disease affected by lifestyle and psychological factors,and the key lies in patients’ self-management.At present,there has been no report on the effect of RICE consultation combined with individual paper health prescription on patients’ self-management ability.Objective:The purpose of this study is to study the influence of the routine consultation mode combined with RICE consultation and individual paper health prescription on the self-management ability(patient enablement and self-management behavior)of hypertension patients in the community,so as to provide reference for the discussion of the medical treatment and prevention integration consultation mode that promotes residents’ mental health and healthy lifestyle.Methods:1.A total of 146 patients with hypertension who went to the general department of Shuangfeng Temple Central Health Center from January 2020 to December 2020 were selected,and all of them met the criteria of diagnosis,inclusion and exclusion.The enrolled patients(146 cases)were randomly divided into control group(73 cases)and study group(73 cases).Patients in the control group were given the routine consultation mode,while patients in the research group were given the routine consultation mode combined with RICE consultation and personalized paper version of health prescription.2.During the waiting period(i.e.,before the physician’s visit),patients’ general information was collected by a research assistant and their self-management behavior was rated.Patient Enablement Instrument(PEI)score was performed after diagnosis and treatment.The self-management behavior score was evaluated again at telephone follow-up 1 month later.The changes of self-management ability including PE and self-management behavior of hypertension patients in the two groups were statistically analyzed.Results:1.Comparison of baseline data.Compared with the general data of the two groups,such as the monthly family income,age,combined and complicated chronic diseases,P was > 0.05.The scores and total scores of self-management behavior of patients in the two groups before treatment were > 0.05,indicating that the differences were not statistically significant2.The total score of PEI,the positive rate of PEI and the proportion of PEI≥6 were compared.The total PEI score in the control group was 2(0,5),and the total PEI score in the study group was 6(3,8).PEI ≥1 was 65.73% in the control group and 89.04% in the study group.The proportion of PEI≥6 in the control group was 15.07%,and the proportion of PEI ≥ 6 in the study group was 50.68%.The differences between the two groups were statistically significant(all P < 0.05).3.The improvement of PEI items was compared.Comparison of PEI items between the two groups showed no statistical significance in understanding their own diseases(Z=-0.960,P=0.337).Compared with the two groups,there were statistically significant differences in the ability to face life(Z=-3.833,P=0.000),to face their own diseases(Z=-6.059,P=0.000),to maintain their health(Z=-2.902,P=0.004),to have confidence in their health(Z=-4.891,P=0.000),and to have the ability to help themselves(all P < 0.05).4.Comparison of scores of self-management behavior before and after treatment in control group.After 1 month of follow-up,the scores of medication management in the control group were higher after the consultation than before the consultation(P=0.009).There was no significant difference between the scores of other items and those before the consultation(all P > 0.05)..5.Comparison of scores of self-management behavior before and after treatment in the study group.After 1 month follow-up,the scores of the six items of self-management behavior in the study group were all higher than those before the consultation,with statistical significance(all P < 0.05).Conclusion:The implementation of RICE consultation and the issuance of individualized paper health prescriptions in community general clinics can better improve the self-management ability of hypertension patients,better promote residents’ mental health and promote the formation of a healthy lifestyle,which is worthy of promotion and application in general clinics. |
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