| Background: Chronic heart failure(Chronic Heart Failure,CHF)brings significant increase in medical expenses,reduced quality of life and reduced life expectancy,affects patients’ family social relations and mental health,is one of the main social public health problems.The clear advantages of telemedicine in chronic disease management provide new ideas for improving the dilemma of CHF.A large number of research results support that CHF patients will benefit from telemedicine.However,poor management efficiency in the practice of telemedicine affects patient benefit.Family care behavior has certain potential and research value in coordinating the efficient use of telemedicine by CHF patients and increasing their own benefits.Objective: To study the effect of family participation behavior on the management of heart failure under telemedicine(MHFT)model,and to analyze the changes in initiation rate,delay rate,willingness to run autonomously and ultimately self-benefit of CHF patients under MHFT mode management.Methods: From January 2018 to March 2018,a total of 86 CHF patients who were managed by the MHFT system of Cardiology Department of Northern Jiangsu People’s Hospital were recruited,and the families of patients’ families were identified by the Family Caregiver Identity Scale(FCIS).Family caregivers(FC)are grouped accordingly: the FC family group(40)and the ordinary family group(46).Provide necessary education to participants and their families,and follow-up management time is 1 year.Patients are required to conduct expert remote video clinics and APP filling once a month.Researchers keep a complete record of each information and check it regularly as required.At the same time,all patients were tracked for HF-related visits,readmissions,medical expenses,and prognosis,and finally included in the data center of the external CHF patient follow-up website for analysis.Results: Statistics were obtained from 84 participants who finalized the study.There were no significant differences in baseline characteristics between the FC family groupand the general family group.The following results were obtained: 1.For the monthly fixed start-up requirements of the MHFT system,there was no significant difference between the two groups in the first month(P = 0.258),the second month(P = 0.377),and the eleventh month(P = 0.066)in the early follow-up period.Besides the difference,the FC family group had significant start-up stability compared with the ordinary family group at the rest of the time(P <0.05).There was no significant difference in the proportion of delayed personnel between the two groups(P> 0.05).2.The FC family group had a stronger willingness to initiate actively,and the average number of assisted video activation(P = 0.001)and instant message interaction(P <0.05)in the follow-up1-9 months was significantly different from the ordinary family group.3.There was no significant difference in the accuracy of medication between the two groups at the beginning of the follow-up(P = 0.292),and the FC family group was significantly higher than the ordinary family group(P <0.05).4.The number of routine cardiology outpatients in the FC family group was significantly higher than that in the ordinary family group(P = 0.039),while the number of HF-related emergency department visits(P = 0.001),HF re-admissions(P = 0.017),and hospitalization costs(P = 0.016)were lower than the average family group.The 6-minute walking distance of FC family group participants was significantly higher than that of ordinary family group(P = 0.041),and the level of B-type natriuretic peptide was significantly reduced(P = 0.036).Conclusions: Family participation behaviors with FC role cognition can effectively improve the MHFT system management effect of CHF patients ’participation,improve participants’ actual activation rate and autonomy,and ultimately reduce HF-related rehospitalization risks and hospitalization costs.The telemedicine chronic disease management system and its further promotion have profound significance. |
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