摘要目的 探讨微信平台实施随访干预对脑卒中患者服药自我管理水平的应用效果.方法 选取某三级甲等医院脑卒中患者70例,根据入院顺序分为对照组和干预组各35例.对照组采用传统出院指导和随访,干预组基于微信平台实施健康教育和行为指导,比较两组患者干预前后服药自我管理能力、认知及行为改变等.结果 干预3个月结束后,干预组患者服药自我管理能力[38(32,42)分]、经验[25(20,28)分]及总分[87(71,92)分]与对照组[能力25(16,38)分;经验21(8.75,27)分;总分68(38,87)分]比较均差异有统计学意义(Z=-2.511,-2.033,-2.209;P＜0.05);干预组干预后服药自我管理认知、能力、经验和总分较干预前均显著增高(Z=-4.525,-4.610,-3.806,-4.718;P＜0.01),对照组干预后仅服药自我管理认知[18(10,24)和13(11,18)]有稍微提高(Z=-1.794,P=0.073).结论 微信平台开展随访干预可有效促进脑卒中患者自我服药管理,提高其服药自我管理能力,但认知的改善可能需要长时间强化指导.

abstractsObjective To explore the impact of WeChat-assisted follow-up on self-administer medication capability of stroke survivors.Methods Seventy patients were recruited from a tertiary hospital and randomly divided into intervention group (n=35) and control group (n=35).Patients in intervention group were given WeChat-assisted follow-up including health education program and behavior guidance,and patients in control group received regular discharge care.The effects of WeChat-assisted follow-up and regular care on self-administer medication ability,cognitive and behavior level were assessed.Results After three months' follow-up,the scores of self-administer medication capability (38 (32,42)),experience (25 (20,28) and the integral level (87 (71,92)) in intervention group were significantly higher than those in control group (capability 25(16,38),experience 21 (8.75,27),total score 68 (38,87)) (Z=-2.511,-2.033,-2.209,P＜0.05).The self-administer medication experience,cognitive,capability and total scores increased significantly in intervention group after intervention(Z=-4.525,-4.610,-3.806,-4.718,all P＜ 0.01),while only the cognitive level increased slightly in control group (18 (10,24) vs 13 (11,18),Z =-1.794,P=0.073).Conclusions Follow-up intervention based on WeChat platform can improve the stroke patients' self-administration medication capability,however,the long-term effects on cognitive level and further reform need to be strengthened.