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

Liuyan Shen,1,* Weigui Jia,2,* Xue Mei,3 Jing Lyu4 1Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support Force of Chinese People’s Liberation Army, National Advanced Stroke Center, Wuxi, People’s Republic of China; 2Department of Neurosurgery, Suzou Kowloon Hospital, Shanghai Jiaotong University Shool of Medicine, Suzou, 215028, People’s Republic of China; 3Department of General Surgery, 904th Hospital of Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People’s Republic of China; 4Department of Neurosurgery, Jiangnan University Medical Center, Wuxi, Jiangsu, 214002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Lyu, Email [email protected]: 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: Baseline characteristics were comparable between groups (all P > 0.05). At 3 months, the observation group showed a significantly higher disease knowledge awareness rate (93.2% vs. 77.3%, χ2= 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.Keywords: cerebrovascular interventional surgery, bundle care, information-knowledge-belief-behavior theory continuity care, multidisciplinary combined treatment and rehabilitation care, effectiveness, impact