基于 IKAP模式的台历式健康教育在脑卒中偏瘫患者康复中的作用 [中文引用][英文引用]

目的  探讨基于信息 - 知识 - 态度 - 行为（information-knowledge-attitude-practice，IKAP）理论模式的台历式健康教育在脑卒中偏瘫患者康复中的应用效果。方法  采用类实验研究，于 2024 年 1 月至 12 月选择本院及 3 家社区卫生服务中心收治的 150 例脑卒中偏瘫患者为研究对象，将本院及 1 家地理位置邻近、康复管理模式匹配的社区卫生服务中心（东西片区）设为试验组，另 2 家社区卫生服务中心（南北片区）设为对照组，每组分别为 75 例。对照组实施常规护理与健康教育，试验组实施基于 IKAP 模式的台历式健康教育。于干预前（基线 T0）、干预后 12w 和 24w 评价患者康复训练依从性、Fugl-Meyer 运动功能评分、Barthel 指数、健康知识掌握度、自我效能与 12w 和 24w 患者的满意度。结果  144 例患者（对照组 71 例，试验组 73 例）完成研究。不同时间点两组患者的康复训练依从性、Fugl-Meyer 运动功能评分、Barthel 指数、健康知识得分及自我效能评分的时间效应、组间效应及交互效应具有统计学意义（均 P<0.001）。干预 12w、24w 后，试验组上述各项指标均优于对照组（均 P<0.001），且试验组干预 24w 各项指标均优于干预前（均 P<0.05）。患者对该健康教育方式满意度高。结论  基于 IKAP 模式的台历式健康教育能有效提升脑卒中偏瘫患者的康复训练依从性，促进运动功能和日常生活能力恢复，并增强其健康知识与自我效能。

Objective To evaluate the effect of calendar-style health education based on the information-knowledge-attitudepractice（IKAP）model on the rehabilitation outcomes of stroke patients with hemiplegia. Methods A quasi-experimental study involving 150 eligible patients recruited from our hospital and three community health centres was conducted. The experimental group comprised patients from our hospital and one geographically adjacent community health centre with a matching rehabilitation management model（east-west sites），while the control group consisted of patients from two other community health centres（north-south sites），with 75 patients per group. Patients in the control group received conventional nursing care and standard health education，whereas those in the experimental group received IKAP based calendar-style health education. Rehabilitation outcomes were assessed at 3 time-points： before intervention（baseline T0），at 12 weeks and 24 weeks after intervention，including rehabilitation training compliance，Fugl-Meyer motor function scores，Barthel index scores，health knowledge mastery，self-efficacy and satisfaction. Results Totally 144 patients completed the study（73 in the experimental group and 71 in the control group）. Time effects，between-group effects，and interaction effects for rehabilitation training compliance，Fugl-Meyer motor function scores，Barthel index scores，health knowledge scores，and selfefficacy scores were all statistically significant across the three time points（all P<0.001）. At 12 weeks and 24 weeks after intervention， all aforementioned indicators in the experimental group were significantly superior to those in the control group（all P<0.001），and all indicators at 24 weeks were significantly improved compared with baseline（all P<0.05）. Patients expressed high level of satisfaction with the educational approach. Conclusion The IKAP model based calendar-style health education effectively enhances rehabilitation training adherence among the stroke patients with hemiplegia，promotes recovery of motor function and activities of daily living，and strengthens health knowledge and self-efficacy.