“信息 -知识 -信念 -行为”模式对老年心脑血管疾病病人自我管理及治疗依从性的影响

目的 探讨"信息-知识-信念-行为"(IKAP)模式对老年心脑血管疾病病人自我管理、治疗依从性的影响.方法 选择2018年1—6月北京市和平里医院收治的82例老年心脑血管疾病病人,按照随机数字表法随机分为IKAP组和对照组,各41例.对照组给予常规诊疗、康复护理及必要的健康教育,IKAP组在此基础上,基于IKAP管理模式给予综合性健康干预,共6个月.采用一般自我效能感量表(GSES)、17项版汉密尔顿抑郁量表(HAMD-17)及遵医行为依从性评估量表评估病人的自我效能、心理状态及治疗依从性变化.结果 管理后,IKAP组HAMD评分[(11.66±3.54)分]显著降低,且低于对照组[(14.78±4.51)分](P<0.05).管理后,两组GSES量表评分明显升高,IKAP组GSES量表评分[(3.34±0.41)分]显著高于对照组[(3.04±0.38)分](P<0.05).管理后,IKAP组遵医行为依从性量表中各维度评分均较管理前明显改善,对照组服药、定期复查的评分明显改善,IKAP组服药[(11.43±2.14)分比(9.42±2.08)分]、饮食[(10.84±1.64)分比(8.35±1.90)分]、锻炼[(11.07±2.18)分比(8.24±2.71)分]、定期复查[(11.48±1.89)分比(10.16±1.53)分]各维度评分及总评分[(44.56±5.02)分比(34.87±4.37)分]均显著高于对照组(P<0.05).结论 IKAP模式能改变老年心脑血管疾病病人疾病认知、不良行为,缓解心理状态,提升自我效能和治疗依从性.

Effects of IKAP model on self-management and treatment compliance in elderly patients with cardiovascular and cerebrovascular diseases

Objective To explore the effect of information-knowledge-attitude-practice (IKAP) management mode on the self-man-agement and treatment compliance in elderly patients with cardiovascular and cerebrovascular diseases.Methods Eighty-two elderlypatients with cardiovascular and cerebrovascular diseases who were admitted to Beijing Hepingli Hospital from January 2018 to June2018 were selected and randomly assigned into IKAP group (n=41) and control group (n=41). The control group was given routine diag-nosis and treatment, rehabilitation nursing and necessary health education, and the IKAP group was given comprehensive health inter-vention based on the IKAP management model for 6 months. General self-efficacy scale (GSES), 17-item Hamilton depression scale (HAMD-17) and compliance assessment scale were used to evaluate patients'' self-efficacy, psychological status and treatment compli-ance.Results After management, HAMD score in IKAP group [(11.66±3.54) score] was decreased significantly, which was significant-ly lower than that in control group [(14.78±4.51) score] (P<0.05). After management, GSES scale scores of the two groups were signifi-cantly increased, and GSES scale scores of the IKAP group [(3.34±0.41) score] were significantly higher than that of the control group[(3.04±0.38) score] (P<0.05). After management, compliance assessment scale scores of all dimensions in the IKAP group were signifi-cantly improved, and scores of medication and regular review in the control group were significantly improved. Scores of all dimensionsincluding taking medication [(11.43±2.14) score vs. (9.42±2.08) score], diet [(10.84±1.64) score vs. (8.35±1.90) score], exercise [(11.07± 2.18) score vs. (8.24±2.71) score], check up regularly [(11.48±1.89) score vs. (10.16±1.53) score] and total scores [(44.56±5.02) score vs. (34.87±4.37) score] in the IKAP group were significantly higher than those in the control group (P<0.05).Conclusions IKAP mod-el can effectively change the disease cognition and bad behavior of elderly patients with cardiovascular and cerebrovascular diseases,release the state of emotion, improve self-efficacy and treatment compliance.