曾丽 范天丽 陈传英 林金生 马娟娟

〔摘要〕 目的 探讨应用微信平台进行延续护理对老年慢性疼痛患者自我效能及生活质量的影响。方法 将100例老年慢性疼痛患者随机分为对照组、实验组，每组各50例，对照组采用常规电话随访，实验组在对照组基础上采用微信平台进行延续护理指导，观察比较两组患者出院时和出院3个月后自我效能感及生活质量评分。结果 （1）出院3个月后，除对照组功能性自我效能感评分外，两组患者其他自我效能感评分均较出院时提高，差异有统计学意义（P<0.05）；实验组均高于对照组，差异有统计学意义（P<0.05）。（2）出院3个月后，实验组评分均有提高，差异有统计学意义（P<0.05）；对照组除躯体疼痛、精神健康、总体健康外，其余各维度评分均有提高，差异有统计学意义（P<0.05）；实验组生活质量各维度评分均高于对照组，差异有统计学意义（P<0.05）。结论 微信平台可提高老年慢性疼痛患者的自我效能和生活质量，从而提高出院患者延续护理服务质量。

〔关键词〕 老年；慢性疼痛；微信平台；延续护理；自我效能感；生活质量评分

〔中图分类号〕R47；R248 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2018.08.027

〔Abstract〕 Objective To investigate the effect of extended care through the WeChat platform on the self-efficacy and quality of life in elderly patients with chronic pain. Methods A hundred elderly patients with chronic pain were randomly divided into control group （n=50） and experimental group （n=50）. The control group was regularly followed up by telephone. The experimental group was given extended care through the WeChat platform in addition to the regular follow-up. Self-efficacy and quality of life score at the time of discharge and 3 months post-discharge were compared between the two groups. Results All self-efficacy scores， except the functional self-efficacy score in the control group， were significantly higher at 3 months post-discharge in both groups （P<0.05）， and were significantly higher in the experimental group than in the control group （P<0.05）. Each subscale score was significantly increased at 3 months post-discharge in the experimental group （all P<0.05）， while all scores except those of body pain， mental health， and overall health were significantly increased at 3 months post-discharge in the control group （all P<0.05）. Furthermore， all subscale scores of quality of life were also significantly higher in the experimental group than in the control group （all P<0.05）. Conclusion The WeChat platform can improve the self-efficacy and quality of life in elderly patients with chronic disease， and enhance the quality of extended care services for discharged patients.

〔Keywords〕 elderly； chronic pain； WeChat platform； extended care； self-efficacy； quality of life score

疼痛在國际上被认为是继体温、脉搏、血压和呼吸之后的第五大生命体征。现代医学认为慢性疼痛是一种受到生物、心理、社会等多种因素影响的特殊疾病。流行病学调查显示，有慢性疼痛病史者可占人口的25%～30%，而老年慢性疼痛患者占老年人口的50%～75%[1]。中医学早在《内经》中对疼痛就有了比较完整的认识：“寒气……客于脉中则气不通，故卒然而痛”，“脉泣则血虚，血虚则痛”等提出了不通则痛的观点[2]。微信平台基于微信用户无需安装下载，主要特点为应用触手可及、用完即走，个人、企业、政府等组织均可基于微信开发平台接口开发自己的小程序[3]。针对慢性疼痛具有治愈率低且反复发作的特点，深圳市南山区蛇口人民医院中医科运用微信平台向老年慢性疼痛出院患者提供中西医相结合的延续护理服务，取得了良好的效果，现报道如下。