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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (04) : 485 -489. doi: 10.3877/cma.j.issn.1674-6902.2023.04.007

论著

创新智能健康教育与随访管理对肺结节患者焦虑的影响随机对照研究
蒋丽, 王晓慧, 李维益, 苟双芸, 丁敏, 杨丽†()   
  1. 400042　重庆，重庆医科大学附属第一医院呼吸与危重症医学科
  • 收稿日期:2023-02-22 出版日期:2023-08-25
  • 通信作者: 杨丽
  • 基金资助:
    重庆市科卫联合项目(2020FYYX109); 重庆市中青年高端医学人才项目(20202czzx2108/2020GDRC029); 国家癌症中心，国家抗肿瘤药物临床应用监测网; 2021年度肿瘤规范化诊疗中青年研究基金项目(DSS-YSF2022-10); 重庆医科大学未来医学青年创新团队项目(W0102)

Influence of innovative intelligent health education and follow-up management on anxiety of patients with pulmonary nodules: a randomized control trial

Li Jiang, Xiaohui Wang, Weiyi Li, Shuangyun Gou, Min Ding, Li Yang†()   

  1. Department of Respiratory and Critical Care Medicine.The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
  • Received:2023-02-22 Published:2023-08-25
  • Corresponding author: Li Yang
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蒋丽, 王晓慧, 李维益, 苟双芸, 丁敏, 杨丽. 创新智能健康教育与随访管理对肺结节患者焦虑的影响随机对照研究[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 485-489.

Li Jiang, Xiaohui Wang, Weiyi Li, Shuangyun Gou, Min Ding, Li Yang. Influence of innovative intelligent health education and follow-up management on anxiety of patients with pulmonary nodules: a randomized control trial[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(04): 485-489.

目的

通过随机对照研究分析智能健康教育与随访管理对肺结节患者焦虑的影响。

方法

选择2019年1月至2020年8月我院呼吸与危重症医学科肺结节专病门诊就诊后加入肺结节与肺癌智能管理云平台未确诊的肺结节患者进行焦虑评估。收集患者人口统计学资料，采用汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale, HAMA)用于评估患者焦虑症状。剔除基线调查时无焦虑患者，最终纳入582例可能焦虑或明确焦虑的肺结节患者作为研究对象。患者加入全程管理时分为智能健康教育与随访管理为观察组291例和人工随访管理为对照组291例，进行个体化的疾病科普宣教。加入全程管理3个月后再次进行焦虑评估。

结果

两组患者加入肺结节与肺癌全程管理时人口统计学资料、HAMA评分等无显著性差异。加入全程管理3月后智能健康教育与随访管理组HAMA评分(6.88±2.4)显著低于人工随访管理组HAMA评分(9.06±3.41)(P＝0.001)。

结论

智能健康教育与随访管理能有效缓解未确诊肺结节人群的焦虑状态，值得临床应用。

关键词: 健康教育, 随访, 肺结节, 焦虑, 随机对照研究
Objective

To analyze the impact of intelligent health education and follow-up management on anxiety in patients with pulmonary nodules through a randomized control trial.

Methods

Anxiety assessment was conducted on patients with undiagnosed pulmonary nodules who visited the Respiratory and Critical Care Medicine Department′s outpatient clinic for pulmonary nodules at the First Affiliated Hospital of Chongqing Medical University between January 1, 2019, and August 31, 2020, and subsequently joined the Pulmonary Nodules and Lung Cancer Intelligent Management Cloud Platform. Patient demographic data were collected, and the Hamilton Anxiety Rating Scale (HAMA) was used to evaluate the severity of anxiety symptoms. After excluding patients without anxiety at baseline, 582 patients with possible or definite anxiety were included in the study. At the time of enrollment, patients were assigned to the intelligent health education and follow-up management group (n=291) or the manual follow-up management group (n=291) for individualized disease-related education. Anxiety assessments were repeated three months after joining the comprehensive management.

Results

There were no significant differences in demographic data or HAMA scores between the two groups at the time of enrollment in the Pulmonary Nodules and Lung Cancer Comprehensive Management. Three months after joining the comprehensive management, the HAMA score in the intelligent health education and follow-up management group (6.88±2.4) was significantly lower than that in the manual follow-up management group (9.06±3.41) (P=0.001).

Conclusion

Intelligent health education and follow-up management can effectively alleviate the anxiety of undiagnosed pulmonary nodule patients, and it is worth further promotion and application.

Key words: Health education, Pulmonary nodules, Follow-up management, Anxiety, Randomized control trial
表1 582例肺结节临床资料基线特征[n(%)]
临床资料 观察组(n＝291) 对照组(n＝291) 合计(n＝582) χ2值 P值
年龄       1.140 0.286
<40岁 37(44.6) 46(55.4) 83    
≥40岁 254(50.9) 245(49.1) 499    
性别       4.147 0.042
男 127(55.2) 103(44.8) 230    
女 164(46.6) 188(53.4) 352    
吸烟史       0.774 0.379
是 73(53.3) 64(46.7) 137    
否 218(49.0) 227(51.0) 445    
戒烟情况       3.612 0.166
已戒 39(60.9) 25(39.1) 64    
未戒 34(46.6) 39(53.4) 73    
二手烟暴露       0.786 0.375
是 192(48.7) 202(51.3) 394    
否 99(52.7) 89(47.3) 188    
既往疾病       0.007 0.934
有 142(53.3) 141(46.7) 283    
无 149(49.0) 150(51.0) 299    
肿瘤家族史       0.462 0.497
有 173(48.9) 181(51.1) 354    
无 118(51.8) 110(48.2) 228    
有无呼吸道症状       0.295 0.587
有 84(48.3) 90(51.7) 174    
无 207(50.7) 201(49.3) 408    
结节个数       0.007 0.934
单个 136(50.2) 135(49.8) 271    
多个 155(49.8) 156(50.2) 311    
距离初诊的月数       0.016 0.899
≤1 month 255(50.0) 256(50.0) 511    
>1 month 36(50.0) 35(50.0) 71    
HAMA评分       0.460 0.795
≤6分 0(00.0) 0(00.0) 0    
7~14分 249(50.4) 245(49.6) 494    
15~21分 37(46.8) 42(53.2) 79    
22~29分 5(55.6) 4(44.4) 9    
>29分 0(00.0) 0(00.0) 0    
表2 两组患者干预前后HAMA评分差异比较(分)
组　别 例数 干预前 干预后 t值 P值
观察组 291 10.91±3.65 6.88±2.43 31.018 0.000
对照组 291 11.12±3.67 9.06±3.41 24.917 0.000
t值   －0.691 －8.877    
P值   0.490 0.000    
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