本文選題：哮喘 + 疾病管理��； 參考：《中國全科醫(yī)學(xué)》2017年28期

【摘要】：目的研發(fā)基于移動(dòng)互聯(lián)網(wǎng)技術(shù)的兒童哮喘自我管理工具并予以臨床應(yīng)用實(shí)踐,初步探索移動(dòng)互聯(lián)網(wǎng)技術(shù)應(yīng)用于兒童哮喘自我管理的臨床價(jià)值。方法根據(jù)兒童哮喘管理的基本要素,研發(fā)基于Android手機(jī)操作系統(tǒng)的兒童輕松呼吸遠(yuǎn)程管理APP,測試并優(yōu)化APP的使用功能。選取2016年2—6月在首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院過敏反應(yīng)科就診并確診的64例支氣管哮喘患兒,根據(jù)患兒監(jiān)護(hù)人的意愿,分為APP管理組28例和傳統(tǒng)日記卡管理組36例。APP管理組采用智能手機(jī)下載APP,遠(yuǎn)程管理哮喘患兒;傳統(tǒng)日記卡管理組采用傳統(tǒng)紙質(zhì)版日記卡記錄哮喘患兒癥狀、用藥等情況。比較管理前和隨訪1個(gè)月后兩組患兒的哮喘控制率、兒童哮喘控制測試(C-ACT)得分,隨訪1個(gè)月后兩組患兒用藥依從性、自我管理執(zhí)行情況[記錄癥狀天數(shù)和記錄峰值呼氣流速(PEFR)天數(shù)],并評估患兒監(jiān)護(hù)人對APP管理的滿意度和認(rèn)可度。結(jié)果完成1個(gè)月隨訪的APP管理組患兒18例,傳統(tǒng)日記卡管理組患兒33例。管理前和管理1個(gè)月后,兩組患者支氣管哮喘控制率、C-ACT得分比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);管理后,兩組患兒支氣管哮喘控制率、C-ACT得分均高于管理前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。管理1個(gè)月后,兩組患兒用藥依從性、記錄PEFR天數(shù)比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);記錄癥狀天數(shù)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。APP管理組16例哮喘患兒監(jiān)護(hù)人中,對APP管理的滿意度為93.7%(15/16),認(rèn)可度為81.3%(13/16)。結(jié)論兒童哮喘自我管理工具有較高的接受度和滿意度,但在提高哮喘控制率、C-ACT得分及用藥依從性方面沒有顯著優(yōu)勢,未來需進(jìn)一步優(yōu)化APP功能,并開展大樣本隨機(jī)對照研究。
[Abstract]:Objective to develop a self-management tool for childhood asthma based on mobile Internet technology and to explore the clinical value of mobile Internet technology in childhood asthma self-management. Methods according to the basic elements of childhood asthma management, the remote management of children breathing easily based on Android mobile operating system was developed, and the function of app was tested and optimized. Sixty-four children with bronchial asthma who were diagnosed in the allergic reaction Department of Beijing Children's Hospital affiliated to Capital Medical University from February to June 2016 were selected according to the wishes of the child guardian. App management group was divided into two groups: app management group (n = 28) and traditional diary card management group (n = 36). App management group used smart phone to download app for remote management of asthmatic children, while traditional diary card management group used traditional paper diary card to record symptoms and medication of asthmatic children. The control rate of asthma and the score of C-ACT were compared between the two groups before and after 1 month follow-up. The drug compliance of the two groups was observed after one month follow-up. Self-management performance [record symptom days and record peak expiratory flow rate (PEFR) days] and assess the child's guardian's satisfaction and recognition with app management. Results 18 cases of app management group and 33 cases of traditional diary card group were followed up for 1 month. Before and after one month of management, there was no significant difference in the control rate of bronchial asthma between the two groups (P 0.05), but the control rate of bronchial asthma in the two groups was higher than that before management, and the difference was statistically significant (P 0.05). After one month of management, there was no significant difference in drug compliance and PEFR days between the two groups, and there was no significant difference in the number of symptom days between the two groups, and the difference was statistically significant in 16 guardians of asthmatic children in the control group. Satisfaction with app management was 93. 7 / 16, and recognition was 81. 3 / 16. Conclusion Children asthma self-management tools have higher acceptance and satisfaction, but there are no significant advantages in improving asthma control rate and drug compliance, and further optimization of app function is needed in the future, and a large sample randomized controlled study is carried out.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院過敏反應(yīng)科;北京市通州區(qū)婦幼保健院兒科;首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院耳鼻咽喉頭頸外科;
【基金】：北京市科技計(jì)劃課題(Z131100006813044)
【分類號】：R562.25;TP311.56
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本文編號：2039105