Construction Of Health Promotion Modeland Empirical Reasearch Of Intervention In Patients With Metabolic Syndrome

ObjectiveTo explore the status quo and relationship between self-management ability,lifestyle,psychological flexibility,quality of life in patients with Metabolic syndrome(MS).Through randomized controlled clinical trials to explore the effect of Health Promotion model to the MS patients' self-management behaviour and health outcome.So that we can add chronic management theory and improve the health outcome,and provide theoretical and empirical evidence of targeting interventions for community care.Methods1.A total of 389 patients with MS in one Community Health Center in Taian city were investigated with cross-sectional survey by using Chronic Disease Self-management Study Measures(CDSMS),Connor-Davidson Resilience Scale(CD-RISC),Health-promoting Lifestyle Profile(HPLP),Quality of life scale(SF-36),to test the self-management ability,lifestyle,Psychological flexibility,quality of life and so on.Data were processed using SPSS(Statistical Package for the Social Sciences)22.0 software.Pearson correlation techniques were used to examine the relationship between quality of life,self-management behavior,lifestyle,Psychological flexibility.2.120 inpatients from one Community Health Center were recruited for study.Participants were divided into experimental group and control group by random,Totally twelve patients were excluded for losting follow up,At the end,there are 56 patients for control group and 52 patients for experimental group.They were both assessed on the self-management behaviour,lifestyle,Psychological flexibility,quality of life,Total Cholesterol(TC),Fasting Blood-glucose(FB),weight,Body Mass Index(BMI),Trigly geride(TG),High Density Lipoprotein(HDL),Low Density Lipoprotein(LDL),Interleukin 6(IF-6),Tumor Necrosis Factor ?(TNF-?)and the features of HDL before intervention,After intervention,patients of experimental group were given indivso on.Idualized health education on telephone.The basic information from the patients in two groups were gathered on admission,after 3 months and 6 months,related materials were gathered again and comparatively analyzed.SPSS 22.0 statistical software was used for descriptive analysis,chi-square test,t test,repeated measures,stepwise multiple regression analysis,hierarchical regression analysis etc.P< 0.05 was statistically significant.Results1.Quantitative research results: Firstly,the total score of self-management behaviour in patients with MS was 130.18±23.38;The total score of Psychological flexibility was 60.87±17.28,lifestyle was 127.67±28.03,The total score of quality of life was 55.64± 26.19.Secondly,patients' self-management behaviour was positive correlated with the quality of life(r=0.730,P<0.01),lifestyle(r=0.666,P<0.01)and Psychological flexibility(r=0.789,P<0.01).Thirdly,Gender,Educational level,Main source of life,Physical activity,Pressure management,Interpersonal relationships and Self-improvement can signi ficantly predict the level of self-management,all the variables could explain 83.5%(P<0.01)of the self-management ability,among them Physical activity,Pressure management,Interpersonal relationships and Self-improvement were positively predict the level of selfmanagement ability(P<0.01).Fourthly,All the variables could explain 78.2% of the variance of quality of life.The education level,The main source of income,The per capita income of the family,Self-realization,Interpersonal relationship,Nutrition and Pressure management and Exercise can significantly predict the quality of life.Fifthly,The selfmanagement ability of patients with metabolic syndrome can directly affect the quality of life(direct effect = 0.22),but also indirectly affect the quality of life(indirect effects 0.07 and 0.49,respectively)through lifestyle and psychological elasticity.2.Totally twelve patients were excluded for losting follow up,there are 56 patients for control group and 52 patients for experimental group.Before the intervention,there were no significant differences between the intervention groups and the control group in the scores of the studying variables.Both experimental group and control group in diffent time points of before intervention,3 months after intervention and 6 months after intervention within the same group data was analysed by repeated measures analysis of variance showed that: MS patients' level of self-management ability(time effect P<0.01,group effects P<0.01),level of lifestyle(time effect P<0.01,group effects P<0.01),Psychological flexibility(time effect P<0.01,group effects P<0.01)and quality of life(time effect P<0.01,group effects P<0.01)were all gradually increased along with the extension of time after intervention in intervention groups and the control group.Secondly,The Health Promoting intervention on the FB,LDL had a significant effects(P<0.05).Independentsample t-test showed that at three months after the end of the intervention,The MS patients' Blood-glucose(FB),Total Cholesterol(TC),Triglyceride(TG),and Low Density Lipo protein(LDL)was significant lower in intervention group than in control group.The MS patients' diastolic Blood Pressure(DBP),Blood-glucose(FB),Triglyceride(TG),Low Density Lipoprotein(LDL)was significant lower in intervention group than in control group,While the function of HDL were changed between intervention group and control group at the 6 months after the intervention.Conclusions1.Sex,age,stress management and interpersonal relationship can significantly predict the level of self-management ability.The level of the self-management ability,psychological elasticity and lifestyle of patients with metabolic syndrome were positively correlated with quality of life.2.The self-management ability of patients with metabolic syndrome can directly affect the quality of life directly,but also indirectly affect the quality of life through lifestyle and psychological elasticity.Lifestyle can also indirectly affect the quality of life through psychological elasticity.3.The levels of CDSMS,CD-RISC,HPLP and SF-36 in patients with metabolic syndrome can improve the blood lipid,blood glucose and blood pressure,improve the level of HDL-C and improve the function of HDL-C in patients with metabolic syndrome.