Lorig Kate R, Ritter Philip L, Dost Ayesha, Plant Kathryn, Laurent Diana D, McNeil Ian
Stanford University School of Medicine, Stanford Patient Education Research Center, 1000 Welch Rd, Palo Alto, CA 94306, USA.
Chronic Illn. 2008 Dec;4(4):247-56. doi: 10.1177/1742395308098886.
Evaluate the effectiveness of an online self-management programme (EPP Online) for England residents with long-term conditions.
A prospective longitudinal study. Data were collected online at baseline, 6 and 12 months. The intervention was an asynchronous 6-week chronic-disease self-management programme offered online. We measured seven health status measures (health distress, self-rated health, illness intrusiveness, disability, fatigue, pain and shortness of breath), four behaviours (aerobic exercise, stretching exercise, stress management and communications with physician), and five utilization measures (GP visits, pharmacy visits, PT/OT visits, emergency visits and hospitalizations). We also measured self-efficacy and satisfaction with the health care system.
A total of 568 completed baseline data: 546 (81%) completed 6 months and 443 (78%) completed 1 year. Significant improvements (p < 0.01) were found at 6 months for all variables except self-rated health, disability, stretching, hospitalizations and nights in hospital. At 12 months only decrease in disability, nights in hospital and hospitalizations were not significant with reduction in visits to emergency departments being marginally significant (p = 0.012). Both self-efficacy and satisfaction with the health care system improved significantly.
The peer-led online programme conditions appears to decrease symptoms, improve health behaviours, self-efficacy and satisfaction with the health care system and reducing health care utilization up to 1 year.
评估一项针对英格兰患有长期疾病居民的在线自我管理计划（EPP Online）的有效性。
一项前瞻性纵向研究。在基线、6个月和12个月时通过在线方式收集数据。干预措施是一个为期6周的在线慢性病自我管理计划，该计划为异步进行。我们测量了七项健康状况指标（健康困扰、自我评估健康状况、疾病侵扰、残疾、疲劳、疼痛和呼吸急促）、四项行为（有氧运动、伸展运动、压力管理以及与医生的沟通）和五项医疗利用指标（全科医生就诊、药房就诊、物理治疗/职业治疗就诊、急诊就诊和住院）。我们还测量了自我效能感以及对医疗保健系统的满意度。
共有568人完成了基线数据收集：546人（81%）完成了6个月的随访，443人（78%）完成了1年的随访。除自我评估健康状况、残疾、伸展运动、住院次数和住院天数外，所有变量在6个月时均有显著改善（p < 0.01）。在12个月时，只有残疾、住院天数和住院次数的减少不显著，而急诊就诊次数的减少接近显著（p = 0.012）。自我效能感和对医疗保健系统的满意度均有显著提高。
由同伴主导的在线计划似乎可以减轻症状、改善健康行为、自我效能感以及对医疗保健系统的满意度，并在长达1年的时间内减少医疗保健的利用。
