The Value Of An IMB Model-based Health Education Approach For Secondary Prevention In Patients With Ischaemic Stroke

Objective:To observe the effect of health education based on the IMB model on the control of risk factors and medication adherence of ischaemic stroke patients,and to explore the health education model that can improve the secondary prevention of ischaemic stroke patients.Methods:Using a convenience sampling method,we selected 346 patients first hospitalized for acute ischemic stroke in a tertiary care hospital in Taiyuan City from July 2021 to December 2021 for the study according to the inclusion and exclusion criteria.We randomly divided the study subjects into an intervention group and a control group,with173 cases in each group.The control group received conventional health education.The intervention group received IMB model-based health education based on traditional health education,including health education sessions during hospitalization and post-discharge telephone follow-ups.Blood pressure,fasting blood glucose,and LDL cholesterol values were collected at discharge and three months after release to compare the two groups.We assessed Medication adherence and prognosis using the Morisky Medication Adherence Scale-8 items and the Modified Rankin Scale.Results:1.A total of 346 patients were included in this study and 40 patients were excluded,resulting in 306 patients completing follow-up,156 in the control group and 150 in the intervention group.Among the excluded patients,there were 6 cases of relapse and 1case of death.2.There was no statistical difference between the two groups regarding general information,comorbidities,smoking history,and alcohol consumption(p > 0.05).3.At three months of discharge,systolic blood pressure(137.84±11.72 mm Hg)and diastolic blood pressure(80.92±10.87 mm Hg)decreased in the intervention group compared to the control group and at baseline,with a statistically significant difference(p<0.05).At three months of discharge,fasting blood glucose(7.37±1.81 mmol/L)decreased in the intervention group compared to the control group and at baseline,with a statistically significant difference(P<0.05).At three months of discharge,LDL values in the intervention group(1.66±0.52 mmol/L)decreased compared to the control group and at baseline,with a statistically significant difference(P<0.05).At three months of discharge,LDL values in the control group decreased compared to baseline,which was statistically different(p<0.001),but the proportion of patients in the intervention group achieving target LDL values increased compared to the control group,which was statistically different(p=0.019).4.At three months of discharge,the medication adherence to antiplatelet,lipid-lowering and glucose-lowering drugs was higher in the intervention group than in the control group,with a statistically significant difference(p < 0.05).5.At three months of discharge,there was no statistically significant difference in the proportion of good prognosis between the two groups(80.0% vs.78.8%,P > 0.05),and the recurrence rates were 1.32% and 2.48% respectively,with no statistical difference(P > 0.05).Conclusion:1.The IMB model-based health education approach was more effective in promoting the control of blood pressure,fasting glucose and low-density lipoprotein in patients with ischaemic stroke than the general health education approach.2.The IMB model-based health education approach is more effective in promoting adherence to antiplatelet,lipid-lowering and glucose-lowering medications in patients with ischaemic stroke than the general health education approach.