慢病管理模式对类风湿性关节炎患者生活质量的影响

目的探讨慢病管理模式对类风湿性关节炎患者生活质量的影响。 方法将中国医科大学附属第一医院风湿免疫科2018年10月至2019年2月收治的100例类风湿性关节炎患者作为研究对象，采用随机抽签法将患者分为观察组和对照组，各50例。对照组采用常规护理，观察组采用慢病管理模式。采用独立样本t检验比较2组干预6个月后的疾病管理知识掌握、血液指标、自我效能、生活质量的差异。 结果干预6个月后，观察组在疾病基础知识、日常生活、药物治疗、病情监测、关节保护和功能锻炼的疾病管理知识评分分别为（3.21±1.05）分、（4.87±1.21）分、（4.91±1.55）分、（3.72±1.02）分、（4.21±1.24）分、（5.32±1.75）分，高于对照组的（2.24±0.76）分、（3.35±0.94）分、（3.84±1.27）分、（2.38±1.14）分、（3.05±0.98）分、（4.38±1.24）分，差异均具有统计学意义（t=5.764、7.015、5.505、6.194、5.190、3.099，P均<0.05）。观察组患者类风湿性因子、红细胞沉降率、C反应蛋白分别为（13.48±3.27）U/ml、（23.23±5.81）mm/h、（15.34±4.36）mg/L，低于对照组的（16.59±4.18）U/ml、（28.65±5.74）mm/h、（18.77±4.83）mg/L，差异均具有统计学意义（t=4.144、4.693、3.727，P均<0.001）。观察组的一般自我效能、达成结果、自我管理、应对问题的评分分别为（3.74±0.98）分、（3.95±0.89）分、（3.87±0.84）分、（4.17±1.15）分，高于对照组的（2.92±0.74）分、（2.97±0.75）分、（2.94±0.73）分、（3.26±0.93）分，差异均具有统计学意义（t=4.772、5.954、5.910、4.351，P均<0.001）。观察组患者在心理领域、生理领域、社会领域、健康自我认识方面生活质量评分分别为（3.72±1.15）分、（6.20±2.24）分、（5.43±1.37）分、（3.53±1.25）分，高于对照组的（1.59±0.57）分、（3.06±1.32）分、（3.21±1.08）分、（1.35±0.49）分，差异均具有统计学意义（t=11.735、8.540、8.998、11.481，P均<0.001）。 结论慢病管理模式能够增强类风湿性关节炎患者的疾病管理知识掌握和自我效能，改善疾病状态，提高生活质量。

Influence of chronic disease management model on quality of life of patients with rheumatoid arthritis

ObjectiveTo explore the influence of chronic disease management model on the quality of life of patients with rheumatoid arthritis. MethodsA total of 100 patients with rheumatoid arthritis admitted to Department of Rheumatology and Immunology, the First Affiliated Hospital of China Medical University from October 2018 to February 2019 were randomly divided into either an observation group or a control group, each with 50 cases. Routine nursing was used in the control group and chronic disease management model was used in the observation group. Independent sample t-test was used to compare the knowledge of disease management, blood indexes, self-efficacy, and quality of life between the two groups after 6 months of intervention. ResultsAfter 6 months of intervention, the scores of disease management knowledge, daily life, medication, condition monitoring, joint protection, and functional exercise in the observation group were 3.21±1.05, 4.87±1.21, 4.91±1.55, 3.72±1.02, 4.21±1.24, and 5.32±1.75, respectively, all of which were significantly higher than those of the control group (2.24±0.76, 3.35±0.94 3.84±1.27, 2.38±1.14, 3.05±0.98, and 4.38±1.24, respectively; t=5.764, 7.015, 5.505, 6.194, 5.190, and 3.099, respectively; P<0.05). The rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein in the observation group were (13.48±3.27) U/ml, (23.23±5.81) mm/h, and (15.34±4.36) mg/L, all of which were significantly lower than those of the control group (16.59±4.18) U/ml, (28.65±5.74) mm/h, and (18.77±4.83) mg/L, respectively; t=4.144, 4.693, and 3.727, respectively; P<0.001). The scores of general self-efficacy, conclusion, self-management, and coping problems in the observation group were 3.74±0.98, 3.95±0.89, 3.87±0.84, and 4.17±1.15, respectively, all of which were significantly higher than those of the control group (2.92±0.74, 2.97±0.75, 2.94±0.73, and 3.26±0.93, respectively; t=4.772, 5.954, 5.910, and 4.351, respectively; P<0.001). The quality of life scores in psychological domain, physical domain, social domain, and healthy self-awareness the in observation group were 3.72±1.15, 6.20±2.24 5.43±1.37, and 3.53±1.25, respectively, all of which were significantly higher than those of the control group (1.59±0.57, 3.06±1.32, 3.21±1.08, and 1.35±0.49, respectively; t=11.735, 8.540, 8.998, and 11.481, respectively; P<0.001). ConclusionChronic disease management model can enhance the knowledge and self-efficacy of rheumatoid arthritis patients on disease management and improve the disease status and quality of life.