2019年冠状病毒病大流行期间，2型糖尿病患者虚拟多学科护理计划的可行性与可接受性

Feasibility and acceptance of a virtual multidisciplinary care programme for patients with type 2 diabetes during the COVID-19 pandemic.

作者信息

Hernández-Jiménez Sergio, García-Ulloa Ana Cristina, Alcántara-Garcés María Teresa, Urbina-Arronte Luz Elena, Lara-Sánchez Carolina, Velázquez-Jurado Héctor Rafael

机构信息

Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Colonia Sección XVI, Tlalpan, 14080 Mexico City, Mexico.

出版信息

Ther Adv Endocrinol Metab. 2021 Nov 24;12:20420188211059882. doi: 10.1177/20420188211059882. eCollection 2021.

DOI:10.1177/20420188211059882

PMID:34868545

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8637687/

Abstract

BACKGROUND AND AIMS

Type 2 diabetes mellitus is one of the major public health concerns. The current lifestyle and advances in technology resulted in the development of a virtual mode of professional healthcare, which is an effective alternative method of management of patients. This study aimed to assess the feasibility of implementation of a virtual comprehensive care programme during the COVID-19 pandemic, patients' acceptance and the changes in self-care behaviours, metabolic parameters and emotional factors.

METHODS

The programme employed in this study included nine health interventions in 1 day. Due to the COVID-19 pandemic, the mode of interventions, including questionnaires, patient evaluations and a satisfaction survey, was modified to the virtual form in 2020. This study assessed the changes in self-care behaviours, metabolic parameters and emotional factors and compared the data pertaining to patients who received virtual healthcare in 2020 with those who received face-to-face modality of medical care in 2019.

RESULTS

During June to November 2020, 130 patients received healthcare by means of the virtual modality. The change in modality of healthcare was feasible and 75% of the patients displayed good acceptance of the same. The evaluation of self-care behaviours included self-monitoring blood glucose (SMBG) levels, foot care and regular exercise. The duration of exercise decreased from 120 to 0 min/week ( < 0.001). However, there was no change in metabolic parameters. Regarding the mental health parameters, we observed an increase in the proportion of patients with anxiety (21.5% 11.1%), depressive symptoms (10.8% 4.3%), diabetes distress (18.5% 11.1%) and prescription of psychotropic drugs (32.8% 18.2%) ( < 0.05) in virtual face-to-face, respectively.

CONCLUSION

The virtual comprehensive care programme for the management of patients with diabetes is a feasible approach that allows healthcare professionals to provide an adequate care during the COVID-19 pandemic.

摘要

背景与目的

2型糖尿病是主要的公共卫生问题之一。当前的生活方式和技术进步催生了专业医疗保健的虚拟模式，这是管理患者的一种有效替代方法。本研究旨在评估在新冠疫情期间实施虚拟综合护理计划的可行性、患者的接受度以及自我护理行为、代谢参数和情绪因素的变化。

方法

本研究采用的计划包括在一天内进行九项健康干预。由于新冠疫情，2020年将包括问卷调查、患者评估和满意度调查在内的干预方式改为虚拟形式。本研究评估了自我护理行为、代谢参数和情绪因素的变化，并将2020年接受虚拟医疗保健的患者数据与2019年接受面对面医疗护理的患者数据进行了比较。

结果

2020年6月至11月期间，130名患者通过虚拟方式接受了医疗保健。医疗保健方式的改变是可行的，75%的患者对此表示良好接受。自我护理行为评估包括自我监测血糖（SMBG）水平、足部护理和定期锻炼。锻炼时长从每周120分钟降至0分钟（<0.001）。然而，代谢参数没有变化。关于心理健康参数，我们观察到虚拟组与面对面组相比，焦虑患者比例增加（21.5%对11.1%）、抑郁症状患者比例增加（10.8%对4.3%）、糖尿病困扰患者比例增加（18.5%对11.1%）以及精神药物处方比例增加（32.8%对18.2%）（<0.05）。