以漫画为核心的“互联网+”健康管理模式对中青年心血管病高危人群的管理效果评价

李夏; 陈玉娇; 陈丽丽; 程鎏; 陆春宇; 徐晓英

doi:10.16766/j.cnki.issn.1674-4152.002462

以漫画为核心的“互联网+”健康管理模式对中青年心血管病高危人群的管理效果评价

doi: 10.16766/j.cnki.issn.1674-4152.002462

上海市静安区江宁路街道社区卫生服务中心，上海 200041

基金项目:

上海市全科医学临床质量控制研究项目 HQKZKYJ004

详细信息

通讯作者:
徐晓英, E-mail: 2696051559@qq.com

中图分类号: R54 R499
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出版历程
- 收稿日期: 2021-01-15
- 网络出版日期: 2022-09-05

Evaluation of the effect of the "Internet plus" health management model core with comics on the management of young and middle-aged people at high risk of cardiovascular disease

Jiangning Road Street Community Health Service Center, Jing'an District, Shanghai 200041, China

摘要

摘要: 目的探索一种以漫画为核心的新型“互联网+”健康管理模式(以下简称新型管理)在中青年心血管病高危人群(以下简称高危人群)管理中的应用效果。方法选取2019年2—4月在上海某街道写字楼员工中筛选出118例高危人员, 通过随机数字表法分为新型管理组及常规管理组，每组各59例。所有人员入组后填写健康知识测验，并对其进行6个月的健康管理。6个月后再次填写风险评估问卷及医学知识测验。对比分析2组理化指标、知行指标、失访率及满意度。结果干预后，新型管理组与常规管理组在BMI降幅[1.3(0.9, 1.6) vs. 0.9(0.3, 1.3)]、收缩压降幅[20.0(14.5, 23.0) mm Hg vs. 16.0(12.0, 19.0) mm Hg, 1 mm Hg=0.133 kPa]、舒张压降幅[10.0(14.5, 23.0) mm Hg vs. 8.0(5.0, 9.0) mm Hg]、LDL-C降幅[1.1(0.7, 1.3) mmol/L vs. 0.7(0.2, 1.0) mmol/L]、血压监测次数及健康知识知晓程度比较差异均有统计学意义(均P＜0.05)，2组健康知识知晓程度干预前后比较差异有统计学意义(P＜0.05)。干预后，新型管理组吸烟量低于干预前(P＜0.001)；新型管理组失访率低于常规管理组(P＜0.05)；服务满意度比例高于常规管理组(P＜0.05)。结论将新型管理模式用于高危人群，能增加该类人群对疾病及自身状态的了解，提高血压、血脂、BMI、吸烟量的控制水平，增强依从性，提高满意度。
- 互联网+ /
- 中青年 /
- 心血管病高危人群 /
- 健康管理
Abstract: Objective To explore the application effect of the new 'Internet plus' health management model with comics as the core (new management for short) in the management of young and middle-aged people at high risk of cardiovascular disease (high-risk population for short). Methods A total of 118 cases were selected from office buildings around a street in Shanghai from February through April 2019 as the research objects. They were divided into a new management group (n=59) and a conventional management group (n=59) by simple random grouping. All personnel completed the health knowledge test after joining the group and carried out health management for six months. After 6 months, the two groups filled out the risk assessment questionnaire and health knowledge test again. The physical and chemical indexes, knowledge and behaviour indexes, loss to follow-up rate and satisfaction rate of the two groups were compared and analysed. Results After the intervention, the reduction of BMI [1.3 (0.9, 1.6) vs. 0.9 (0.3, 1.3)], systolic blood pressure [20.0 (14.5, 23.0) mm Hg vs. 16.0 (12.0, 19.0) mm Hg, 1 mm Hg=0.133 kPa], diastolic blood pressure [10.0 (14.5, 23.0) mm Hg vs. 8.0 (5.0, 9.0) mm Hg], LDL-C [1.1 (0.7, 1.3) mmol/L vs. 0.7 (0.2, 1.0) mmol/L], the frequency of blood pressure monitoring and the health knowledge awareness level in the new management group were higher than those in the conventional management group (all P < 0.05). Moreover, significant differences were observed in the health knowledge awareness level before and after the intervention between the two groups (P < 0.05). After the intervention, the smoking volume in the new management group was lower than that before the intervention (P < 0.001). The loss to follow-up rate in the new management group was lower than that in the conventional management group (P < 0.05). The proportion of service satisfaction was higher than that in the conventional management group (P < 0.05). Conclusion Applying the new management model to the health management of high-risk population can increase their understanding of diseases and their own status. It can also improve the control level of blood pressure, blood lipids, BMI and smoking, enhance compliance, and improve satisfaction.
- Internet plus /
- Young and middle-aged people /
- High-risk population of cardiovascular disease /
- Health management

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表 1 2组人群管理模式比较

Table 1. Comparison of crowd management mode between two groups

组别	宣教载体	触达途径	监测模式	趣味性	参与模式	人力分配
新型管理组	科普漫画	手机微信客户端	手机端记录平台，可显示变化趋势，有提醒功能	以漫画为主，文字为辅，风趣幽默	医患共同参与	医师挑选适宜科普漫画及制定规则，由信息人员负责发送及维护
常规管理组	现场讲解+文字版健康教育手册	需到达现场	纸质版记录表	纯文字，表述平淡，缺乏趣味性	以医生为主导，患者被动接受	医师联系现场宣教组织者，现场宣讲、派发健康教育手册

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表 2 2组人群一般资料比较

Table 2. Comparison of general data between the two groups

组别	例数	性别[例(%)]		年龄[M(P₂₅, P₇₅)，岁]	文化程度[例(%)]			BMI(x±s)	收缩压[M(P₂₅, P₇₅)，mm Hg]	舒张压[M(P₂₅, P₇₅)，mm Hg]	空腹血糖(x±s，mmol/L)	LDL-C[M(P₂₅, P₇₅)，mmol/L]
组别	例数	女性	男性	年龄[M(P₂₅, P₇₅)，岁]	初高中	大学(含专科)	硕士及以上	BMI(x±s)	收缩压[M(P₂₅, P₇₅)，mm Hg]	舒张压[M(P₂₅, P₇₅)，mm Hg]	空腹血糖(x±s，mmol/L)	LDL-C[M(P₂₅, P₇₅)，mmol/L]
新型管理组	59	32(54.2)	27(45.8)	46(43, 48)	4(6.8)	48(81.4)	7(11.9)	26.3±1.8	150(146, 153)	92(90, 95)	5.4±0.6	3.6(3.2, 3.8)
常规管理组	53	30(56.6)	23(43.4)	46(44, 49)	4(7.5)	42(79.2)	7(13.2)	26.4±1.9	150(146, 153)	94(90, 96)	5.3±0.6	3.6(3.2, 3.8)
统计量		0.063^a		1 497.000^b	3 003.500^b			-0.186^c	1 616.000^b	1 521.500^b	0.833^c	1 489.500^b
P值		0.801		0.699	0.940			0.853	0.761	0.808	0.407	0.667
注：^a为χ²值，^b为W值，^c为t值。1 mm Hg=0.133 kPa。

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表 3 2组人群干预后BMI、LDL-C、血压降幅比较[M(P₂₅, P₇₅)]

Table 3. The reduction of BMI, LDL-C and blood pressure between the two groups after intervention were compared [M(P₂₅, P₇₅)]

组别	例数	BMI降幅	LDL-C降(mmol/L)	血压降幅(mm Hg)
组别	例数	BMI降幅	LDL-C降(mmol/L)	收缩压降幅	舒张压降幅
新型管理组	59	1.3(0.9, 1.6)	1.1(0.7, 1.3)	20.0(14.5, 23.0)	10.0(14.5, 23.0)
常规管理组	53	0.9(0.3, 1.3)	0.7(0.2, 1.0)	16.0(12.0, 19.0)	8.0(5.0, 9.0)
W值		2 053.500	2 269.500	1 964.000	2 201.000
P值		0.004	＜0.001	0.020	＜0.001

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表 4 2组人群干预后吸烟量比较[例(%)]

Table 4. Comparison of smoking quantity between two groups after intervention[cases (%)]

组别	例数	干预前吸烟量(支/d)				干预后吸烟量(支/d)
组别	例数	0	1~10	11~20	20以上	0	1~10	11~20	20以上
新型管理组	59	32(54.2)	8(13.6)	11(18.6)	3(5.1)	41(69.5)	16(27.1)	2(3.4)	0^a
常规管理组	53	31(58.5)	10(18.9)	7(13.2)	1(1.9)	32(60.4)	10(18.9)	10(18.9)	1(1.9)^b
W值		2 880.500				3 216.000
P值		0.461				0.125
注：与组内干预前比较，^aP＜0.001，^bP=0.625。

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表 5 2组人群干预后血压监测依从性、健康知识知晓程度比较

Table 5. Comparison of blood pressure monitoring compliance and health knowledge between the two groups after intervention

组别	例数	血压测量次数[例(%)]			健康知识知晓程度[M(P₂₅, P₇₅)]
组别	例数	优	良	差	干预前	干预后
新型管理组	59	22(37.3)	30(50.8)	7(11.9)	0.52(0.45, 0.62)	0.71(0.62, 0.81)^a
常规管理组	53	3(5.7)	32(60.4)	18(34.0)	0.57(0.52, 0.62)	0.62(0.57, 0.62)^b
W值		3 647.000			1 274.500	2 348.000
P值		＜0.001			0.090	＜0.001
注：与组内干预前比较, ^aP < 0.001, ^bP < 0.05。

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表 6 2组人群失访率及服务满意度比较[例(%)]

Table 6. Comparison of loss to follow-up rate and service satisfaction between the two groups[cases (%)]

组别	例数	是否失访		满意度
组别	例数	是	否	满意	一般	不满意
新型管理组	59	0	59(100.0)	49(83.1)	9(15.3)	1(1.7)
常规管理组	53	6(10.2)	53(89.8)	17(32.1)	30(56.6)	6(11.3)
统计量		4.390^a		3 803.500^b
P值		0.036		＜0.001
注：^a为χ²值，^b为W值。

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