Research On The Effect Of Nursing Intervention Based On Chronic Illness Trajectory Model In Patients Of Ulcerative Colitis

ObjectivesBased on the chronic illness trajectory model(CITM),we attempt to understand the real experience and needs of the patients with ulcerative colitis(UC)from the diagnosis phase,acute phase and remission phase.And to analyze the causes,formulates the dynamic changes of the patients in nursing intervention measures,and to explore the influence and role of nursing intervention from the pattern on the quality of life,self-management ability and anxiety depression in patients with UC.MethodsThis study is a randomized controlled trial study.We selected 88 UC patients who met the exclusion criteria in a top three hospital in Tianjin from June to December 2019 as the research object.A randomized method was used to select 88 patients according to the order of admission.Sequential numbering,and then use SPSS 23.0 software to set the random seed number,the number of 88 patients was divided into two groups according to the ratio of 1:1through the software,44 cases in each group,1 to 44 into the test group,45 to 88 enter the control group.The control group adopted routine health education,and the intervention group adopted a nursing intervention program based on chronic disease trajectory model on the basis of routine nursing.The intervention time ranged from the second day after admission to4 weeks after discharge.Before the intervention,the general data and disease data questionnaire prepared by ourselves were used to collect the general data of the patients.After three different periods of nursing intervention in the acute period and remission period of UC patients,the inflammatory bowel disease quality of life questionnaire(IBDQ),hospital anxiety and depression scale(HAD)and chronic disease self-management behavior scale were used two groups of patients were investigated.Data was collected using Epidata3.1software,statistical analysis was performed using SPSS23.0 software,and all tests were conducted using a two-sided test.P<0.05 indicates statistical significance.Demographic data and disease-related data of the two groups of patients,count data using frequency and percentage description,2 tests for statistical analysis,grade data using Mann-Whitney U test;measurement data using mean±standard deviation(~?x±s)description,Two-sample independent t test was used for statistical analysis.The anxiety,depression,quality of life,and self-management behavior scores of the two groups of patients in each period before and after the intervention were expressed as mean±standard deviation(~?x±s),and repeated measures were used for analysis.Results1.General data and disease data:In this study,a total of 8 subjects fell off,and a total of80 patients were finally included,including 41 in the intervention group and 39 in the control group.There was no statistically significant difference between the two groups of patients in terms of age,gender,education,work status,monthly family income,medical payment methods,family history,and disease severity(P>0.05).The baseline of disease data is consistent and comparable.2.The scores of quality of life,anxiety,depression and self-management behavior of the two groups of patients before intervention were not statistically significant(P>0.05).The baseline quality of life of the two groups of patients was consistent and comparable.3.Mann-Whitney U test compared the quality of life,anxiety,depression,and self-management behavior scores of the two groups of patients at different periods.The data showed that the quality of life and self-management of the intervention group during the acute period and remission period.The behavior scores were higher than the control group,and the anxiety and depression score intervention group was lower than the control group,the difference was statistically significant(P<0.05).The results of repeated measures analysis of variance between the two groups showed that the inter-group effects,time effects and interaction effects of the two groups of patients were statistically significant(P<0.05).Conclusions1.Nursing intervention based on the chronic disease trajectory model can improve the quality of life of patients with ulcerative colitis.2.Nursing intervention based on the chronic disease trajectory model can improve the self-management level of patients with ulcerative colitis.3.Nursing intervention based on the chronic disease trajectory model can reduce the level of anxiety and depression in patients with ulcerative colitis.