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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2023年04期

页码:

485-489

栏目:

论著

出版日期:

2023-08-20

文章信息/Info

Title:

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

作者:

蒋 丽; 王晓慧; 李维益; 苟双芸; 丁 敏; 杨 丽

400042 重庆,重庆医科大学附属第一医院呼吸与危重症医学科

Author(s):

Jiang Li;  Wang Xiaohui;  Li Weiyi;  Gou Shuangyun;  Ding Min;  Yang Li.

Department of Respiratory and Critical Care Medicine.The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China.

关键词:

健康教育;  随访;  肺结节;  焦虑;  随机对照研究

Keywords:

Health education;  Pulmonary nodules;  Follow-up management;  Anxiety;  Randomized control trial

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2023.04.007

摘要:

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。

Abstract:

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.

参考文献/References:

1 李咏生, 孙建国, 李梦侠, 等. 第三代EGFR-TKI耐药后诊疗策略专家共识[J/CD]. 中华肺部疾病杂志(电子版), 2023, 16(2): 145-155.
2 杨 丽, 钱桂生. 肺结节临床精准诊断的新理念[J/CD]. 中华肺部疾病杂志(电子版), 2022, 15(1): 1-5.
3 Oudkerk M, Liu S, Heuvelmans MA, et al. Lung cancer LDCT screening and mortality reduction-evidence, pitfalls and future perspectives[J]. Nat Rev Clin Oncol, 2021, 18: 135-151.
4 McWilliams A, Tammemagi MC, Mayo JR, et al. Probability of cancer in pulmonary nodules detected on first screening CT[J]. N Engl J Med, 2013, 369(10): 910-919.
5 Church TR, Black WC, Aberle DR, et al. Results of initial lowdose computed tomographic screening for lung cancer[J]. N Engl J Med, 2013, 368(21): 1980-1991.
6 Kalin NH. Novel insights into pathological anxiety and anxiety-related disorders[J]. Am J Psychiatry, 2020, 177(3): 187-189.
7 Xiao R, Huang Y, Meng S, et al. A cross-sectional study of psychological burden in Chinese patients with pulmonary nodules: Prevalence and impact on the management of nodules[J]. Thorac Cancer, 2021, 12(23): 3150-3156.
8 Smith Z, Barnett SA, Gorelik A, et al. Strategies for the managementof solitary pulmonary nodules: A Survey of patient preferences[J]. Ann Thorac Surg, 2022, 113(5): 1670-1675.
9 Zimmerman M, Thompson JS, Diehl JM, et al. Is the DSM-5 anxious distress specifier interview a valid measure of anxiety in patients with generalized anxiety disorder: a comparison to the Hamilton anxiety scale[J]. Psychiatry Res, 2020, 286: 112859.
10 李瑞芹. 个性化健康教育在肺小结节伴焦虑及抑郁患者中的应用[J]. 山东医学高等专科学校学报, 2022, 44(1): 15-17.
11 杨小琴, 郭铃艳, 许 茗. 基于信息-动机-行为技能模型的健康教育在老年肺结节患者健康管理中的应用观察[J]. 老年医学与保健, 2022, 28(2): 420-423, 430.
12 陈瑞祺, 周胜红. 肺结节与焦虑的相关性探析[J/OL].中医药信息:1-5[2023-05-17].http://43.138.60.40/kcms/detail/23.1194.R.20230315.1651.004.html
13 吴俊翰, 庄伟涛, 许海杰, 等. 肺结节患者焦虑、抑郁情绪及其影响因素的横断面研[J]. 中国胸心血管外科临床杂志, 2023, 30(3): 357-363.
14 娄月妍, 吴学玲, 范碧君, 等. 肺结节患者心理健康状况及影响因素分析[J/CD]. 中华肺部疾病杂志(电子版), 2021, 14(6): 729-733.
15 陈 冀, 邓才霞, 张厚丽, 等. 高危肺结节患者认知及焦虑状况调查分析[J/CD]. 中华肺部疾病杂志(电子版), 2023, 16(2): 164-168.
16 Wang XH, Wang T, Min A, et al. Prevalence and characteristics of anxiety in patients with unconfirmed pulmonary nodules[J]. Clin Respir J, 2023, 17(3): 157-164.
17 喻 静, 刘 林, 龚卫娟. 反刍思维在肺结节患者领悟社会支持与焦虑及抑郁情绪中的中介作用[J]. 实用临床医药杂志, 2023, 27(7): 45-50.
18 Slatore CG, Wiener RS. Pulmonary nodules: a small problem for many, severe distress for some, and how to communicate about it[J]. Chest, 2018, 153(4): 1004-1015.
19 Li L, Zhao Y, Li H. Assessment of anxiety and depression in patients with incidental pulmonary nodules and analysis of its related impact factors[J]. Thorac Cancer, 2020, 11(6): 1433-1442.
20 Zeng L, Tao Y, Hou W, et al. Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: a randomized controlled trial[J]. Medicine(Baltimore), 2018, 97(34): e11905.
21 Freiman MR, Clark JA, Slatore CG, et al. Patients'Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey[J]. J Thorac Oncol, 2016,11(5): 700-708.
22 Xiao R, Huang Y, Meng S, et al. A cross-sectional study of psychological burden in Chinese patients with pulmonary nodules: Prevalence and impact on the management of nodules[J]. Thorac Cancer, 2021,12(23): 3150-3156.
23 Slatore CG, Golden SE, Ganzini L, et al. Distress and patient-centered communication among veterans with incidental(not screen-detected)pulmonary nodules. A cohort study[J]. Ann Am Thorac Soc, 2015, 12(2): 184-192.
24 Martini K, Eberhard M, Frauenfelder T. [Pulmonary nodules-an overview][J]. Ther Umsch, 2020, 77(2): 75-80.
25 Zhuang W, Wu J, Xu H, et al. Exploring the psychological profile: a cross-sectional study of 1,185 patients with pulmonary nodules in an outpatient clinic[J]. J Thorac Dis, 2022,14(12): 4699-4712.
26 Wang XH, Liu XF, Ao M, et al. Cerebral Perfusion Patterns of Anxiety State in Patients With Pulmonary Nodules: A Study of Cerebral Blood Flow Based on Arterial Spin Labeling[J]. Front Neurosci, 2022, 16: 912665.
27 Zhao B, Li Z, Wang Y, et al. Can acupuncture combined with SSRIs improve clinical symptoms and quality of life in patients with depression? Secondary outcomes of a pragmatic randomized controlled trial[J]. Complement Ther Med, 2019, 45: 295-302.
28 Wang Z, Dong H, Wang Q, et al. Effects of electroacupuncture on anxiety and depression in unmarried patients with polycystic ovarian syndrome: secondary analysis of a pilot randomised controlled trial[J]. Acupunct Med,2019, 37(1): 40-46.
29 Martiny K. Novel Augmentation Strategies in Major Depression[J]. Dan Med J, 2017, 64(4): B5338.
30 Buhmann CB. Traumatized refugees: morbidity, treatment and predictors of outcome[J]. Dan Med J, 2014, 61(8): B4871.
31 张 莉, 王云霞, 李 静, 等. 智能手机应用程序在鼻科住院患者健康教育中的应用[J]. 中华护理杂志, 2016, 51(10): 1243-1244.
32 梁存禹, 赵 倩, 宋 宁, 等. 基于“互联网+”的可穿戴式心电设备在冠心病患者PCI术后慢病管理中的应用效果评价[J]. 上海交通大学学报(医学版), 2022, 42(3): 275-281.
33 黄 靖, 陈宪泽, 沈富儿, 等. 基于移动互联网的社区慢性病健康教育模式研究[J]. 中国健康教育, 2020, 36(6): 580-583.
34 骆惠玉, 张风贞, 齐 榕, 等. “互联网+”肿瘤患者健康教育方案的构建[J]. 中华护理杂志, 2017, 52(12): 1482-1485.
35 谭 峰, 曹允芳, 许翠萍, 等. 住院患者健康教育评价方案研究进展[J]. 中华护理教育, 2011, 8(12): 571-572.

备注/Memo

备注/Memo:

收稿日期:2023-02-22)
基金项目: 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)
通信作者: 杨 丽, Email: 204534@hospital.cqmu.edu.cn

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更新日期/Last Update: 2023-08-20