The Effectiveness Of WeChat-based Transitional Care On Hyperphosphatemia In Patients With Chronic Kidney Disease

Objective:The purpose of this experimental design study is to investigate the effectiveness of WeChat-based transitional care on hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis.Methods:(1)A total of 161 hemodialysis patients were enrolled at the nephrology department of the Affiliated Hospital of SOUTHWEST Medical University between 1st July 2016 and15 th July 2016.A face-to-face,self administered questionnaire survey,named WeChat usage questionnaire in chronic kidney disease patients,was conducted to investigate the need for WeChat-based transitional care on hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis(2)We organized a transitional care team composed with dietitians,doctors and nurses based on the demand analysis of WeChat transitional care platform for hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis.Then,we set up the WeChat Official Subscription Account,entitled "hyperphosphatemia forum",to Push the relevant Message of hyperphosphatemia,including dietary guidance,medication guidance and other services.In addtion,We established a WeChat communication group,named The nephrology patients of the Affiliated Hospital of Southwest medical university including doctors,dietitians,nurses,patients with chronic kidney disease,to spread and exchange the related knowledge of transitional care in chronic kidney disease patients.(3)Then,a total of 52 hemodialysis patients,from the nephrology department of the Affiliated Hospital of SOUTHWEST Medical University untill the 1st August 2016,were included as the subject investigated,this cilents received WeChat-based transitional care based on same care modality,types of medicine and conventional care.The method of this study is a self pre-and post-control observation.Our concrete measures in details included: we applied the therapeutic doctor-patient communication function of the WeChat transitional care platform to promote the dissemination of knowledge of chronic kedney disease along with the Morbidity and mortality of hyperphosphatemia,improve the patient compliance on hyperphosphatemia management,and strengthen the theoretical knowledge about dietary guidance,medication guidance,life tips etc,and through the WeChat group communication,patients and their relatives would obtain timely answers to their desease bewilderment.The ultimate aim was to enhance the self-management ability on hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis and fill the gaps of lacking of nursing intervention at home after dialysis simultaneously.Self-made questionnaire and MMAS-8 were used to survey cognition of hyperphosphatemia knowledge and health behavior changes in patients before and after one-month intervention.The levels of serum phosphorus,calcium and calcium phosphorus product of patients were detected by biochemical test before and after three months intervention.All results were typed-in Epidata 3.1.The level of serum phosphorus,drug therapy compliance,cognitive of hyperphosphatemia knowledge and health behavior changes of patients were analyzed by SPSS 21.0.Results:(1)According to our requirement Investigation,95.33% of patients used WeChat,79.1% of patients used WeChat every single day,79.02% of patients used Wechat from 18:00 PM to 22:00 PM,58.04% of patients used the circle of friends in WeChat,62.94% of patents used WeChat Official Account,46.7% of patients focused on WeChat Official Account about the public health.(2)The cognitive and attitude results of the WeChat-based transitional care in chronic kidney disease patients with hyperphosphatemia is that 81.36% of patients want to manage blood dialysis by internet.If there was a WeChat Official Account.associated with hemodialysis,16.9% of patients are willing to careful reading,74.6%are willing to regular reading.The favorite services on WeChat Official Account in Chronic kidney disease patients were diet guide(68.49%),health information(60.27%)and medication guide(54.79%).(3)The medication compliance,cognitive of hyperphosphatemia knowledge and health behavior changes of patients were enhanced after intervention(P<0.05),while the level of serum phosphorus,calcium and calcium phosphorus product of patients have no statistical difference after one-month intervention.But the level of serum phosphorus,calciumphosphorus product of patients declined after three-month intervention(P<0.05),and the level of calcium have no statistical difference.Conclusion: In this study,the demand of WeChat-based transitional care on hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis is high and those patients want to obtain completely therapeutic and nursing guidelines including dietary guidelines,health information and medication instructions from WeChat platform.WeChat-based transitional care could not only decline the level of phosphorus and calcium-phosphorus of these patients,but also improve the related knowledge of hyperphosphatemia,diet and medication and promote the establishment of healthy behaviors in patients with chronic renal disease complicated by hyperphosphatemia on maintenance hemodialysis.