Effect Of Health Education Based On IKAP Model On Independent Management Of Patients With DKD

Objective:To explore health education based on the information-knowledge-attitude-practice Model（IKAP Model）in patients with T₂DM（Type 2 diabetes Mellitus,T₂DM）in the prevention of renal disease in patients with self-management.Methods:1.A total of 34 items in the item pool were established according to IKAP theory and related literature,and 20 patients were interviewed face-to-face for pre-survey.Reliability and validity of the questionnaire were tested,and items were screened based on expert consultation results to form a formal questionnaire.2.A total of 100 patients with type 2 diabetic nephropathy（DKD）stageⅢandⅣwere randomly divided into experimental group（n=50）and control group（n=50）.IKAP mode health education and routine health education were implemented respectively.Blood glucose,Glycosylated hemoglobin（Hb A1C）and urinary protein were measured at baseline and final follow-up to evaluate the intervention effect of different health education modes.Results:1.The KAP questionnaire for DKD patients had three dimensions,including knowledge,belief and behavior,29 items in total;The pre-experiment results show that the overall reliability of the questionnaire and the reliability stability of each dimension are acceptable.2.Before health intervention,there were no significant differences in knowledge,belief and behavior scores between the two groups,which were comparable.After health intervention,the scores of knowledge,belief and behavior in the experimental group were significantly higher than those in the control group（P<0.05）.3.In terms of blood glucose monitoring,before the intervention,there were no significant differences in fasting blood glucose and 2hours postprandial blood glucose of Oral glucose tolerance test（OGTT）between the two groups（P>0.05）;After 12 months of intervention,OGTT fasting blood glucose and OGTT 2 hours postprandial blood glucose in the experimental group were significantly lower than those in the control group（P<0.05）.4.From before intervention to 12 months,Hb A1C decreased in the experimental group with statistical significance（P=0.029）;Hb A1C did not decrease in the control group（P=0.629）.5.In terms of urinary protein level,there was no statistical significance in the decrease of urinary protein in the two groups before and after health education（P>0.05）.Conclusions:1.Based on the theoretical framework of the IKAP health education model,the reliability and validity of the KAP questionnaire for DKD patients are acceptable,which is scientific to a certain extent,and can provide a means for clinical and community physicians to evaluate the knowledge,belief and behavior level of DKD patients.2.Health education based on the IKAP model can significantly improve the knowledge level and treatment compliance of DKD patients,improve their belief towards disease,correct unhealthy lifestyles,optimize blood glucose control,and thus improve the self-management level of DKD patients.