運用行動健康醫療介入對於改善冠心病患者生理指數之成效

The Effects of Mobile Health Care on the Physiological Index in Patients With Coronary Artery Disease

背景：冠狀動脈心臟病（冠心病）與不健康的生活型態及高血壓、糖尿病、吸菸、肥胖、高膽固醇血症等疾病相關的危險因子息息相關。目的：本研究旨在探討行動健康醫療對冠心病患者生理指數改善之成效。方法：採實驗設計法，以北部某區域教學醫院心臟內科門診以及病房之冠心病患者共129人，分為實驗組64人與對照組65人。實驗組個案接受為期十二周的行動健康醫療介入；而對照組僅接受門診常規治療。兩組藉由病歷回溯方式查閱患者的相關生理指數包含三酸甘油脂、低密度膽固醇、身體質量指數、收縮壓和舒張壓。採廣義估計方程式（generalized estimating equation）等統計方式，探討介入措施之成效。結果：實驗組前後測的三酸甘油脂降低的數值顯著比對照組平均多39.27 mg／dl（p＜.05）；實驗組前後測的收縮壓和舒張壓降低的數值顯著比對照組多分別為8.32 mmHg和4.24 mmHg（p＜.01）；再者，實驗組前後測的身體質量指數減少的數值也顯著比對照組平均多0.48 Kg／m2（p＜.05）。僅有實驗組前後測的低密度膽固醇降低的數值雖比對照組平均多1.11 mg／dl，但未達統計學上的顯著水準。結論：行動健康醫療對於改善冠心病患者的相關生理指數有顯著的成效。

Background: Coronary artery disease is associated with unhealthy lifestyles such as smoking, lack of physical activity, and consuming an unhealthy diet. Other risk factors include family history and comorbidities such as hypertension, diabetes, smoking, obesity, and hypercholesterolemia. Purpose: This study aims to investigate the effectiveness of mobile health care in improving the physiological index of patients with coronary artery disease. Methods: This study used an experimental design. Convenience sampling was used to enroll 129 patients with coronary heart disease as participants, who were randomly assigned into the intervention group (n = 64) and control group (n = 65). The intervention group participants received a 12-week mobile health care intervention, while the control group participants received routine care in the outpatient department. The physiological index outcome variables included body mass index (BMI), lipid profile, and blood pressure. Data were analyzed using generalized estimating equation curve analysis. Results: The mean triglyceride (TG) reduction value after the intervention in the experimental group was significantly higher (reduction of 39.27 mg/dl; p < .05) than in the control group. Moreover, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) reduction values in the experimental group were significantly higher (reductions of 8.32 mmHg and 4.24 mmHg; p < .01) than in the control group. Furthermore, the mean reduction in BMI value in the experimental group was significantly higher (reduction of 0.48 Kg/m2 ; p < .05) than in the control group. Finally, only the mean reduction in low density lipoprotein (LDL) values was greater (by 1.11 mg/dl) in the experimental group than in the control group. However, this reduction did not reach statistical significance. Conclusions: Mobile health care has the potential to reduce TG, blood pressure, and BMI in patients with coronary artery disease.