Application Of Nursing Intervention Based On IKAP Model In Stroke Patients And Primary Caregivers

Objectives:The study aimed to understand the current situation of stroke knowledge,attitude and practice of stroke patients and primary caregivers,based on the model of(Information-Knowledge-Attitude-Practice,IKAP),to construct a health education intervention program for stroke patients and primary caregivers.To explore the application effect of IKAP model in stroke knowledge,self-efficacy,self-management behavior and quality of life in stroke patients,to explore the application effect of IKAP model in stroke knowledge,attitude,practice and comprehensive care ability of primary caregivers of stroke patients,to provide evidence support for the clinical use of IKAP model in China,and to provide reference for clinical nursing workers to optimize the health education intervention model of stroke patients and primary caregivers.Methods:This is a quasi-experimental study.From March 2022 to November 2022,stroke patients and primary caregivers hospitalized in the Department of Neurology of a hospital in Changchun City were selected as the research objects.There were 88 cases in the intervention group and 88 cases in the control group,including 44 patients and44 primary caregivers in each group.The control group received routine health education,while the intervention group received health education based on IKAP model.The intervention lasted for 3 months and was assessed within 24 hours of admission(T1),before discharge(T2),and at 3 months of discharge(T3).Patient outcomes included: Stroke Knowledge Questionnaire,Stroke Self-Efficacy Questionnaire(SSEQ),Stroke Self-Management Scale(SSMS),Stroke Scale-Quality of Life(SS-QOL);Primary caregiver outcomes include: Primary Caregiver Knowledge,Attitude and Practice Questionnaire and Stroke Caregiver Comprehensive Care Ability Assessment Questionnaire.Use IBM SPSS 26.0 software to analyze and process the data.Results:1.Implementation of intervention process: A total of 176 stroke patients and primary caregivers were included in the study,88 cases in the control group and 88 cases in the intervention group,each group include 44 patients and 44 their primary caregivers.During the intervention,1 pair of patients and primary caregivers in the control group were lost to follow-up,while no patients and primary caregivers in the intervention group were lost to follow-up.2.T1 comparison results of general data: There were no significant differences in demographic data such as gender,age and education level between the two groups(P>0.05).There were no significant differences in demographic data such as gender,age and length of care between the two groups of primary caregivers(P>0.05).3.Comparison of stroke knowledge level,self-efficacy,self-management behavior and quality of life in stroke patients: The t-test results of stroke knowledge level,self-efficacy and self-management behavior of stroke patients showed that there was no significant difference in mean between T1(P>0.05),and the mean difference between T2(P < 0.05)and T3(P < 0.05)was statistically significant.Comparison between the two groups of life and living dimensions in self-management behavior,there was no significant difference in mean between the two groups at T1 and T2(P>0.05),and there was a significant difference in T3(P<0.05).In terms of patients’ quality of life,the results of t-test showed that there was no significant difference in mean between T1(P>0.05),and the difference between T2 and T3 was statistically significant(P<0.05).4.Results of repeated measurement of variance in self-management behavior:There was an interactive effect on treatment × time on self-management behavior.The pairwise comparison of self-management behavior between the two groups showed a statistically significant difference(P<0.05).There were differences in the influence of time factors on the self-management behavior of stroke patients,and the differences between different time points was statistically significant(P<0.05).5.Knowledge,attitude,practice level and comprehensive care ability of the primary caregivers of stroke patients: The results of t-test showed that there was no significant difference in the mean of stroke knowledge,attitude,practice level and comprehensive care ability between the two groups at T1(P>0.05),and there were significant differences in mean between T2 and T3(P<0.05).Conclusions:1.Stroke patients have intermediate levels of knowledge,attitude and practice,and the IKAP model can improve the stroke knowledge,self-efficacy,self-management behavior and quality of life of stroke patients,and is an effective health education intervention model.2.The knowledge,attitude and practice of the primary caregivers of stroke patients were at an moderate level,the IKAP model can improve the knowledge,attitude,practice and comprehensive care ability of the primary caregivers of stroke patients.3.The IKAP model is an effective health education intervention model that can be applied to health education for stroke patients and primary caregivers,which can promote stroke patients to form long-term good self-management behavior and improve the quality of life;It can give full play to the supervision,management and synergy of primary caregivers on patients,improve the comprehensive care ability of primary caregivers,and assist patients to improve adverse health behaviors,and it is recommended for clinical use.