Combined IKAP-Based Continuity Care and Bundle Care in Patients Undergoing Cerebrovascular Interventional Surgery: A Retrospective Study

Background: Cerebrovascular interventional surgery requires comprehensive postoperative care for long-term recovery. While bundle care standardizes acute management, it often lacks structured post-discharge support. This study evaluated the added benefit of combining Information-Knowledge-Attitude-Practice (IKAP) theory-based continuity care with bundle care. Methods: A retrospective comparative study was conducted on 88 patients treated between April 2022 and April 2024. Based on the standard care protocol at admission, patients were non-randomly assigned to a control group (n = 44, receiving bundle care) or an observation group (n = 44, receiving bundle care plus a 3-month IKAP-based continuity care program). The IKAP program included structured WeChat-based education, bi-weekly behavioral coaching, and family support. Outcomes assessed at baseline and 3 months included disease knowledge awareness rate, psychological resilience (Connor-Davidson Resilience Scale, CD-RISC), activities of daily living (Barthel Index, BI), sleep quality (Pittsburgh Sleep Quality Index, PSQI), self-management ability, and patient satisfaction. Analysis of covariance (ANCOVA) was used to compare post-intervention scores between groups, adjusting for baseline values. Results: = 4.423, P = 0.035). After adjusting for baseline scores, the observation group also demonstrated significantly greater improvements in psychological resilience (all CD-RISC subscales, P < 0.001), BI score (adjusted mean: 86.8 vs. 73.9, P < 0.001), PSQI score (8.2 vs. 9.8, P = 0.004), and all domains of self-management (all P < 0.001, with large effect sizes Cohen's d: 1.07-2.18). Overall patient satisfaction was higher in the observation group (90.9% vs. 70.5%, P = 0.020). Conclusion: Integrating IKAP-based continuity care with bundle care was associated with better short-term recovery outcomes compared to bundle care alone after cerebrovascular intervention. This model warrants prospective validation.

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Publication Details

Journal
Patient Preference and Adherence
Published
2026-04-01
DOI
https://doi.org/10.2147/ppa.s565669
Primary Topic
Enhanced Recovery After Surgery
Type
article
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article

Combined IKAP-Based Continuity Care and Bundle Care in Patients Undergoing Cerebrovascular Interventional Surgery: A Retrospective Study

Jing Lyu, Xue Mei, Liuyan Shen, Weigui Jia
Patient Preference and Adherence
Enhanced Recovery After Surgery
article

Combined IKAP-Based Continuity Care and Bundle Care in Patients Undergoing Cerebrovascular Interventional Surgery: A Retrospective Study

Jing Lyu, Xue Mei, Liuyan Shen, Weigui Jia
article en

Abstract

Background: Cerebrovascular interventional surgery requires comprehensive postoperative care for long-term recovery. While bundle care standardizes acute management, it often lacks structured post-discharge support. This study evaluated the added benefit of combining Information-Knowledge-Attitude-Practice (IKAP) theory-based continuity care with bundle care. Methods: A retrospective comparative study was conducted on 88 patients treated between April 2022 and April 2024. Based on the standard care protocol at admission, patients were non-randomly assigned to a control group (n = 44, receiving bundle care) or an observation group (n = 44, receiving bundle care plus a 3-month IKAP-based continuity care program). The IKAP program included structured WeChat-based education, bi-weekly behavioral coaching, and family support. Outcomes assessed at baseline and 3 months included disease knowledge awareness rate, psychological resilience (Connor-Davidson Resilience Scale, CD-RISC), activities of daily living (Barthel Index, BI), sleep quality (Pittsburgh Sleep Quality Index, PSQI), self-management ability, and patient satisfaction. Analysis of covariance (ANCOVA) was used to compare post-intervention scores between groups, adjusting for baseline values. Results: = 4.423, P = 0.035). After adjusting for baseline scores, the observation group also demonstrated significantly greater improvements in psychological resilience (all CD-RISC subscales, P < 0.001), BI score (adjusted mean: 86.8 vs. 73.9, P < 0.001), PSQI score (8.2 vs. 9.8, P = 0.004), and all domains of self-management (all P < 0.001, with large effect sizes Cohen's d: 1.07-2.18). Overall patient satisfaction was higher in the observation group (90.9% vs. 70.5%, P = 0.020). Conclusion: Integrating IKAP-based continuity care with bundle care was associated with better short-term recovery outcomes compared to bundle care alone after cerebrovascular intervention. This model warrants prospective validation.

Patient Preference and AdherenceVol. Volume 20
Jiangnan University (CN), Kowloon Hospital (CN), 117th Hospital of People's Liberation Army (CN), Wuxi No.2 People's Hospital (CN)
Quality Education
Openalex Percentile: Top 24%
Enhanced Recovery After Surgery
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