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Effect of WeChat follow-up for the relatives of diabetic retinopathy patients

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Journal Title:
Chinese Journal of Health Management
Key Word:
糖尿病视网膜病变;血糖;行为;随访;Diabetic retinopathy;Blood glucose;Behavior;Follow-up

Abstract´╝Ü Objective To investigate the effects of WeChat follow-up of relatives on knowledge cognition, change of behavior, visual acuity and blood glucose for diabetic retinopathy (DR) patients.Methods Totally 107 typeⅡdiabetic patients from January 2014 to December 2015 in the Department of Endocrinology were enrolled in the study, with the inclusion criteria of 60 years of age and older and diagnosed with diabetic retinopathy. Subjects were divided into the WeChat group (53 cases) and the control group (54 cases) based on the order of enrollment. The control group was given routine care and health education, while the WeChat group was given additional follow-up of relatives through WeChat with distribution of health education messages for the management of DM and DR once each week for 12 months. Questionnaires were used to collect information on patient's knowledge of DR prevention & treatment and behavior change, FBG, PBG, and HbA1c, and visual acuity were also collected to assess the effectiveness of the intervention. Chi-square test was used to compare the patients' cognitive rate, behavioral change and stage of retinopathy. The t-test was used to compare fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin and visual acuity. Results Cognitive Knowledge change on DR were analyzed for the following questions:the time of the first fundus examination after diagnosis of diabetes and occurrence of systemic complications; what are key measures for prevention of early blindness in patients with DR;fundus checkup requirements while blood glucose control is ideal;types of major eye complications for diabetic patients; when laser treatment should be done for DR patients; how long apart should patients check the fundus;what is the normal range of blood glucose;and the types of server damages of DR;etc. The cognitive rates of WeChat group after follow-up were as follows 88.7%, 67.9%, 56.6%, 96.2%, 79.2%, 67.9%, 69.8%, 94.3%, 75.5%. WeChat group compared with the Control group after follow-up (χ2 values were 16.77, 30.76, 16.30, 7.75, 9.68, 36.03, 9.25, 10.57and 9.41, respectively, all P<0.01), the difference was statistically significant. The results of WeChat group before and after the follow-up were (χ2 values were 19.41, 38.22, 17.90, 8.23, 9.34, 38.22, 21.81, 12.08 and 25.52, respectively, all P<0.01), the difference was statistically significant. The cognitive rate for DR risk factors for the WeChat group was 24.5% before follow-up and 43.4%after follow-up;the after follow-up difference between WeChat group and the Control group was statistically significant (χ2=5.33, P<0.05). WeChat group before and after follow-up comparison (χ2=4.21, P<0.05) was also statistically significant. For values of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin, results of WeChat group before follow-up were as follows (13.18± 4.46) mmol/L, (16.17 ± 3.97) mmol/L, (10.18 ± 2.76)%;results of WeChat group after follow-up were (8.45 ± 2.26) mmol/L, (11.34 ± 2.34) mmol/L,(7.83 ± 1.40)% respectively. The after follow-up comparison between WeChat group and the Control group showed statistically significant differences (t values were-7.06,-7.30, and-6.37, respectively, all P<0.01). Within the WeChat group, before and after follow-up comparison were all significantly different (t values were 6.83, 7.59 and 5.54, respectively, all P<0.01). The vision of WeChat group before follow-up was 0.68 ± 0.18, after follow-up was 0.71 ± 0.20. There were no significant differences in the two groups after follow-up, before and after follow-up WeChat group, the Control group before and after follow-up about visual acuity comparison (t values were 1.02,-1.10, and 0.57, respectively, all P>0.05). The two groups of patients were compared in balanced diet, regular eating time, meal volume, wearing loose clothing and exercise shoes and socks before each exercise, exercising for more than 30 min, weekly checkup of blood glucose, blood sugar test before and after the exercise and other measurements of behavior changes were significantly different (χ2 values were 11.54, 11.77, 13.68, 5.89, 10.23 and 8.72, respectively, all P<0.01 or 0.05). There were no significant differences in self-withdrawal of medication and Retinopathy stageⅠand stageⅡpatients and between these two patient groups (χ2 values were 1.20, 0.01 and 0.01, respectively, all P>0.05). Conclusions The practice of WeChat follow-up of relatives can improve cognition ability for DR patients aged 60 years and older, it can promote the healthy behavior and the BG monitoring effectively.

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