@Article{信息:doi 10.2196 / / jmir。2699，作者="陈丽珍和庄，李明和张，嘉显和王，秋香和王，易晶和钟，余芳和彭，惠宇和陈，惠泉和徐，林玉玲和林玉生和陈，黄仁和张，滕春和江，益德和李，洪昌和谭，清婷和张，欣露和赖飞培"，title="远程医疗项目中糖尿病患者自我管理行为评估:历时18个月的纵向研究”，期刊=《中国医学互联网研究》，年=“2013”，月=“12”，日=“09”，卷=“15”，数=“12”，页数=“e266”，关键词=“互联网;糖尿病;远程医疗;自理;在线系统;个人健康记录;背景:自我管理是糖尿病患者的一项重要技能，它涉及频繁监测血糖水平和行为矫正。促进糖尿病患者行为改变的技术已经开发出来，如糖尿病自我管理教育和远程保健。 Although the patients are engaged in self-management activities, barriers to behavior changes remain and additional work is necessary to address the impact of electronic media and telehealthcare on patient self-care behaviors. Objective: The aims of this study were to (1) explore the behaviors of diabetic patients interacting with online applications, (2) determine the impact of a telehealthcare program among 7 self-care behaviors of the patients, and (3) determine the changes in glycosylated hemoglobin (HbA1c) levels. Methods: A telehealthcare program was conducted to assist the patients with 7 self-care activities. The telehealthcare program lasted for 18 months and included the use of a third-generation mobile telecommunications glucometer, an online diabetes self-management system, and a teleconsultant service. We analyzed the data of 59 patients who participated in the telehealthcare program and 103 who did not. The behavioral assessments and the HbA1c data were collected and statistically analyzed to determine whether the telehealthcare services had an impact on the patients. We divided the 18-month period into 3 6-month intervals and analyzed the parameters of patients assisted by the telehealthcare service at different time points. We also compared the results of those who were assisted by the telehealthcare service with those who were not. Results: There was a significant difference in monitoring blood glucose between the beginning and the end of the patient participation (P=.046) and between the overall period and the end of patient participation (P<.001). Five behaviors were significantly different between the intervention and control patients: being active (P<.001), healthy eating (P<.001), taking medication (P<.001), healthy coping (P=.02), and problem solving (P<.001). Monitoring of blood glucose was significantly different (P=.02) during the 6-12 month stage of patient participation between the intervention and control patients. A significant difference between the beginning and the 6-12 month stage of patient participation was observed for the mean value of HbA1c level (P=.02), and the differences between the overall HbA1c variability and the variability of each 6-month interval was also significant. Conclusions: Telehealthcare had a positive effect on diabetic patients. This study had enhanced blood glucose monitoring, and the patients in the program showed improvements in glycemic control. The self-care behaviors affect patient outcomes, and the changes of behavior require time to show the effects. ", issn="14388871", doi="10.2196/jmir.2699", url="//www.mybigtv.com/2013/12/e266/", url="https://doi.org/10.2196/jmir.2699", url="http://www.ncbi.nlm.nih.gov/pubmed/24323283" }