IKAP健康管理模式对白银市老年心血管高危人群护理效果的影响

Influence of IKAP health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city

目的探讨信息-知识-信念-行为(IKAP)健康管理模式对白银市老年心血管高危人群护理效果的影响。方法本研究为非随机对照试验,采用整群随机抽样法抽取2021年10月至2022年3月于白银市第一人民医院健康管理中心接受体检及护理服务的126例老年心血管高危人群为研究对象。根据患者所选护理方式采用倾向性匹配评分法1∶1入组,接受常规护理的纳入对照组(63例),给予常规健康教育及护理,健康教育通过讲解疾病相关知识,饮食、用药指导等方式进行,1次/周;接受IKAP健康管理模式的纳入IKAP组(63例),在对照组基础上给予IKAP健康管理,通过收集信息、传递知识、转变观念、改变行为方式进行,1次/周。两组均连续干预6个月。比较两组干预前后心理状态[中国心身健康量表(CPSHS)]、自我效能[自知力与治疗态度问卷(ITAQ)]、生活质量[生活质量综合评定问卷(GQOLI-74)]、生活习惯(控制饮食、规律运动、睡眠困难、控制体重)、躯体健康状况[躯体化症状自评量表(SSS)]差异,采用χ2检验比较两组服药率及血压、血糖、血脂达标率差异,分析IKAP健康管理模式对白银市老年心血管高危人群护理效果的影响。结果两组干预后CPSHS评分、睡眠困难率及SSS评分均显著低于干预前[IKAP组,(19.29±4.96)比(31.37±9.23)分、31.75%比73.02%、(37.06±4.30)比(60.16±79.83)分;对照组,(22.93±7.39)比(31.67±9.21)分、52.38%比74.60%、(41.75±4.97)比(60.04±9.95)分],且IKAP组均显著低于对照组(均P<0.05)。两组干预后ITAQ评分、GQOLI-74评分、控制饮食率、规律运动率、控制体重率均显著高于干预前[IKAP组,(17.65±3.65)比(2.41±0.31)分、(83.91±6.04)比(56.26±5.14)分、76.19%比42.86%、57.14%比30.16%、71.43%比42.86%;对照组,(14.35±3.36)比(2.33±0.29)分、(75.25±5.78)比(57.12±5.21)分、57.14%比44.45%、38.10%比28.57%、53.97%比39.68%],且IKAP组均显著高于对照组(均P<0.05)。IKAP组干预后血压、血糖、血脂达标率均显著高于对照组(85.71%比68.25%、90.48%比76.19%、82.54%比66.67%)(均P<0.05)。结论IKAP健康管理模式能有效提高老年心血管高危人群的自我效能,纠正其不良生活习惯,改善心理及躯体状态,有助于控制血压、血糖、血脂,提高生活质量。

Objective To explore the influence of information-knowledge-attitude-practice(IKAP)health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city.Methods In this non-randomized controlled trial,a total of 126 elderly population with high cardiovascular risk who received physical examination and nursing services from October 2021 to March 2022 in the Health Management Center of the First People's Hospital of Baiyin were collected as the research subjects by cluster random sampling method.Using propensity score matching method to enroll patients in a 1∶1 ratio based on their preferred nursing methods,63 patients receiving routine nursing were included in control group and were given routine health education and nursing(health education was given by explaining disease-related knowledge,diet and medication guidance,once a week),and 63 patients who received IKAP health management model were enrolled as IKAP group and were given IKAP health management on the basis of the control group once a week by collecting information,transmitting knowledge,changing ideas and behavior.Both groups were continuously intervened for 6 months.The psychological state[Chinese psychosomatic health scale(CPSHS)],self-efficacy[insight and treatment attitudes questionnaires(ITAQ)],quality of life[generic quality of life inventory-74(GQOLI-74)],lifestyles(controlled diet,regular exercise,sleep difficulties,weight control)and physical health status[somatic self-rating scale(SSS)]were compared between groups before and after the intervention.The medication rate and compliance rates of blood pressure,blood glucose and blood lipid of the two groups were compared by chi-square test,and the influence of IKAP health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city was analyzed.Results The CPSHS score,sleep difficulty rate and SSS score in both groups after intervention were all significantly lower than those before intervention[IKAP group,(19.29±4.96)vs(31.37±9.23)points,31.75%vs 73.02%,(37.06±4.30)vs(60.16±79.83)points;control group,(22.93±7.39)vs(31.67±9.21)points,52.38%vs 74.60%,(41.75±4.97)vs(60.04±9.95)points],and the above-mentioned indicators in IKAP group were all significantly lower than those in the control group(all P<0.05).The ITAQ score,GQOLI-74 score,diet control rate,regular exercise rate and weight control rate were all significantly higher in the two groups after intervention than those before[IKAP group,(17.65±3.65)vs(2.41±0.31)points,(83.91±6.04)vs(56.26±5.14)points,76.19%vs 42.86%,57.14%vs 30.16%,71.43%vs 42.86%;control group,(14.35±3.36)vs(2.33±0.29)points,(75.25±5.78)vs(57.12±5.21)points,57.14%vs 44.45%,38.10%vs 28.57%,53.97%vs 39.68%],and the above-mentioned indicators were all significantly higher in IKAP group when compared with those in the control group(all P<0.05).The compliance rates of blood pressure,blood glucose and blood lipid in IKAP group after intervention were all significantly higherthan those in the control group[(85.71%vs 68.25%,90.48%vs 76.19%,82.54%vs 66.67%)](all P<0.05).Conclusion IKAP health management model can effectively enhance the self-efficacy,correct the poor living habits,improve the psychological and physical states,help to control the blood pressure,glucose and lipid,and enhance the quality of life in elderly population with high cardiovascular risk.