Impact of continuous nursing care based on IKAP theory in patients undergoing cardiopulmonary bypass surgery: a cohort study

BACKGROUND: This prospective study intends to investigate the effect of the Information–Knowledge–Attitude–Practice (IKAP) theory combined with continuous nursing care on patients undergoing cardiopulmonary bypass (CPB) surgery. METHODS: The continuous nursing care based on IKAP theory has been applied in our department since January 2023. Patients discharged from hospital between March 2022 and December 2022 were included in the control group, while patients discharged from hospital between January 2023 and June 2024 were included in the observation group. After discharge for three months, the compliance, self-perception and quality of life of patients in the two groups were evaluated by filling in an online questionnaire. RESULTS: A total of 372 valid questionnaires were received with response rate of 81.6%, including 98 in the control group and 274 in the observation group. The IKAP-based continuous nursing care could significantly improve the compliance rate in vital signs monitoring and lifestyle management (P < 0.05), while there was no significant difference in the compliance rate of therapeutic regimen. The SPBS score of self-perceived burden in observation group was significantly lower than that in control group (P < 0.05), and there were significant improvements in physical burden, emotional burden and economic burden (P < 0.05). The GSES score of self-efficacy in observation group was significantly higher than that in control group (P < 0.05). WHOQOL-BREF score was used to reflect the quality of life. The results showed that the total score of WHOQOL-BREF in observation group was significantly higher than that in control group (P < 0.05). The IKAP-based continuous nursing care significantly improved the quality of life of patients from three dimensions of psychology, physiology and environment (P < 0.05), but has no significant impact on social relations. The readmission rate in observation group was significantly lower than that in control group during the follow-up (P < 0.05). Logistic regression analysis showed that GSES score was an independent protective factor for re-admission. CONCLUSION: Continuous nursing care based on IKAP theory for discharged patients undergoing CPB surgery can effectively improve patients’ compliance and self-efficacy levels, ease their self-perceived burden, and help increase life quality by strengthening their self-management ability after discharge. The bias caused by imbalance in sample size and time-related confounding factors still makes the results of this study require further verification.