Study On The Influence Of Case Management On Self-Management And Quality Of Life Of Glaucoma Patients

Objective:To explore the intervention effect of case management mode on glaucoma patients’ self-management and quality of life,and to provide theoretical and practical basis for improving patients’ compliance behavior and quality of life.Methods:The time span was from January 2019 to June 2019.114 patients hospitalized in the ear,nose and throat treatment center of a class III class a hospital in our province were selected by random number table method.They were divided into control group and observation group,58 in the observation group and 56 in the control group.The observation group was given case management intervention including strengthening professional support,providing opportunities for patients to participate actively,strengthening family support and patient friend support,and the control group was given necessary health education in the outpatient clinic.Glaucoma selfmanagementagement Behavior Questionnaire by self-management behavior questionnaire before,7d after operation,and 1 year after the intervention,comparing the postoperative intraocular pressure,self-efficacy,mean defect and life vision,center and myopia,peripheral vision,chord light and dark adaptation,outdoor activity ability,The self-efficacy scale（General self-efficacy scale,GSES）evaluated the self-efficacy of the two groups.The Chinese version of glaucoma patient quality of life scale（CHI-GQL15 scale）evaluated the quality of life of glaucoma patients,by using Spss22.0 statistical software is used for statistical analysis of all data.The mean±standard deviation（x±s）and frequency composition ratio（%）were used for statistical description;Chi square test is used for counting data,independent sample t-test,nonparametric test and repeated measurement analysis of variance are used for measurement data,and the test level was α=0.05.Results:（1）Baseline data showed that there were no statistically significant differences between the two groups in demographic data,disease status,self-management ability,postoperative intraocular pressure,self-efficacy and quality of life（all P=>0.05）,indicating comparability.（2）Within 1 year after operation,the mean visual field defect and living visual acuity in the observation group were-13.4±7.6dB and 0.48±0.25,respectively,and the mean visual field defect and living visual acuity in the control group were-13.7±6.4dB and 0.47±0.22,respectively.There was no significant difference between the observation group and the control group in the mean visual field defect at baseline and the mean living visual acuity（P>0.05）.（3）Two-way ANOVA was used to compare the trend of intraocular pressure before surgery and within 1 year after surgery in 2 groups.There was no statistical difference in the trend of intraocular pressure before surgery,1d after surgery,7d after surgery and 3 months after surgery（P>0.05）,and the observation group was significantly lower than the control group 6 months,9 months after surgery and 1 year after surgery（P<0.05）.（4）There was no statistical difference in the target intraocular pressure reaching the standard rate between the observation group and the control group 6 months after surgery（P>0.05）,and the target intraocular pressure reaching the standard rate in the observation group was significantly higher than that in the control group 1 year after surgery（P<0.05）.（5）after 1 year of retest results show that the observation group and control group in the central and near vision,peripheral vision,string light and dark adaptation,outdoor activities are rising,and the observation group in the function of health care,medical management score significantly higher than the control group（P<0.05）,two groups of patients in life adjustment score no statistical difference（P>0.05）.（6）The retelling results one year after surgery showed that the self-efficacy score of the observation group was significantly increased,while the score of the control group was not significantly changed,and the observation group was significantly higher than the control group（P<0.05）.（7）CHI-GQL-15 evaluation results showed that after one year of retest results show that the observation group and control group in the central and near vision,peripheral vision,string light and dark adaptation,outdoor activities,four dimensions score rise by different degrees,but these dimensions and the observation group were no statistical difference in postoperative 1 week and control group in peripheral vision,and a marked increase in the outdoor activity ability score（P<0.05）.The scores of peripheral vision and outdoor activity ability in observation group were significantly lower than those in control group one year after operation（P<0.05）.Conclusion:（1）the case management model can improve the postoperative intraocular pressure control effect,which may be of great significance for controlling disease progression and protecting visual function;（2）The case management mode can improve the postoperative self-management ability of glaucoma patients,and promote the improvement of their doctor-prescribed behavior,lifestyle and emotional management;（3）The case management mode can improve the self-management efficiency and quality of life of glaucoma patients,improve the long-term prognosis of patients,and has high application value.