Application Of Nursing Intervention Based On IKAP Model In Self-management Of Patients With Chronic Obstructive Pulmonary Disease

Objective:This study aims to understand the current situation and needs of COPD patients’ self-management ability,clarify the IKAP nursing intervention plan,and explore the impact of this nursing intervention plan on the self-management of COPD patients,so as to improve the patient’s disease management ability,promote their healthy behaviors,and help patients betterMethods:This project adopts a mixed research design method to grasp the self-management ability,self-efficacy status and health guidance needs of COPD patients through the status investigation method;constructs a care intervention plan for COPD patients based on the IKAP model through literature research and expert consultation;verifies through empirical research The application effect of nursing intervention based on IKAP model in self-management of COPD patients.details as follows:1.Current situation investigationTo investigate the current status of self-management ability of COPD patients and analyze the influencing factors,and it is convenient to sample 180 COPD inpatients from the top three general teaching hospitals in Shanxi Province as the survey objects.General survey questionnaires,self-management ability scales,self-efficacy scales,and self-management demand questionnaires were used to conduct current surveys,and a single factor analysis and multiple linear regression analysis of the influencing factors of self-management ability were carried out.2.Scheme constructionBased on the IKAP health education model,combined with the preliminary survey of the current situation and literature research,the first draft of the plan was formed through group discussion,and the final draft of the IKAP nursing intervention plan was formed after three rounds of consultation and pre-experiment with 7 experts.3.Empirical researchConvenient sampling selected 70 COPD patients who met the inclusion and exclusion criteria in two tertiary comprehensive teaching hospitals in Shanxi Province from July to October 2020.The control group(n=35)used conventional health guidance,and the experimental group(n=35))Implement the IKAP nursing intervention program on the basis of it,and compare the two groups of patients’ self-management ability,self-efficacy,m MRC score,CAT score,SGRQ score,disease deterioration and unplanned readmission.Results:1.Current situation survey results(1)The self-management ability score of COPD patients is 143.52±8.47,which is at a moderately low level;(2)The self-efficacy score of COPD patients is 71.27± 9.13,which is at a low level;(3)Multiple linear regression analysis shows age,gender,education level,living status,per capita income,Disease classification and self-efficacy are the influencing factors,which can explain 74.2% of the total variation of the score of self-management ability.2.The result of plan constructionNursing intervention based on the IKAP model includes 4 items for patient personal information mastery(I),17 items for disease-related knowledge intervention(K),5 items for disease management belief intervention(A),and 10 items for health-related behavior intervention(P)A total of 36 items in 4 modules include intervention content,intervention form,intervention time,intervention location,intervention personnel,intervention effect,etc.3.Empirical research results(1)Removal of research subjects: 36 subjects were selected in the intervention group,1 case fell out,and the study was withdrawn due to refusal to follow-up;36 subjects were selected in the control group,1 case fell out,and the study died due to illness.(2)The general information,self-management ability,self-efficacy,m MRC score,CAT score,SGRQ score,and disease deterioration of the two groups were tested for balance before the intervention.The results showed that the difference was not statistically significant(P>0.05)and was comparable.(3)After the intervention,the total scores of self-management ability and the scores of all dimensions of the intervention group were higher than those of the control group at1 month and 3 months after discharge,and the difference was statistically significant(P<0.001);the intervention group was 1 month after discharge,The 3-month self-efficacy scores were higher than those of the control group,and the difference was statistically significant(P<0.001);the m MRC scores and CAT scores of the intervention group were lower than those of the control group at 1 month and 3 months after discharge(P<0.001));The SGRQ scores of patients in the intervention group were lower than those in the control group at 1 and 3 months after discharge(P<0.001);the rate of disease deterioration in the intervention group was lower than in the control group at 1 and 3months after discharge(P<0.05));the unplanned readmission rate of patients in the intervention group was lower than that in the control group one month and three months after discharge(P<0.001).Conclusion:Nursing intervention based on the IKAP model can improve the self-management ability and self-efficacy of COPD patients,improve the symptoms of dyspnea,reduce the impact of the disease on the patients,improve their quality of life,reduce the rate of disease deterioration and unplanned readmissions,and provide clinical care Health guidance and self-management of COPD patients provide a certain reference.