Effect of hospital-community-family health management on self-efficacy and quality of life assessments in discharged patients with nephrotic syndrome / 中华健康管理学杂志

ABSTRACT

Objective:To analyze the effect of hospital-community-family health management on self-efficacy and quality of life (QoL) assessments in discharged patients with nephrotic syndrome (NS).Methods:A total of 102 NS patients who received treatment at the Department of Nephrology in the Affiliated Hospital of Southwest Medical University from January 2018 -January 2019 were selected, and randomized to intervention or control group. The intervention and control group implemented hospital-community-family health management and routine health management for 6 months, respectively. In addition to serum biochemistry and routine urine tests, the general self-efficacy scale (GSES) and QoL (by short form-36 questionnaire; SF-36) assessments were performed in both groups and compared.Results:The levels of 24-hour urine protein, serum creatinine (Scr), blood urea nitrogen (BUN) and plasma albumin, and the GSES and SF-36 assessments were comparable between groups at baseline ( P>0.05). Levels of 24-hour urine protein, Scr and BUN were found to be significantly lower ( P<0.05) in the intervention group than the control group (1.50±0.42 vs. 1.90±0.61 g/L, 152.35±20.31 vs. 185.36±15.59 μmol/L, 7.89±2.01 vs. 10.32±2.35 mmol/L, respectively); however, the intervention group showed a significant increase ( P<0.05) in plasma albumin levels as compared to the control group (32.35±4.48 vs. 29.85±4.35). The intervention group reported significantly higher ( P<0.001) GSES score than the control group (3.00±0.56 vs. 2.45±0.45 points), indicating a better ability of patients in the intervention group to cope up with the daily routine activities. The post-intervention scores of the individual domains, namely overall health, physiological function, physical pain, energy, and mental health, in the SF-36 questionnaire were significantly higher ( P<0.001) in the intervention group than the control group (57.01±4.31 vs. 53.10±4.60 points, 70.06±5.61 vs. 64.02±5.50 points, 65.01±4.31 vs. 61.01±4.80 points, 65.41±5.40 vs. 60.42±5.12 points, 74.40±6.80 vs. 65.42±7.12 points, respectively), implying a better health status in the intervention group. Conclusions:The implementation of hospital-community-family health management during the post-discharge home recuperation period of NS patients can improve their biochemical parameters and QoL, and boost their confidence in the performance of daily routine activities.