Study On The Application Of IKAP Theory Combined With Peer Support In Patients With Non-proliferative Diabetic Retinopathy

ObjectiveBased on IKAP theory,health management intervention strategies were implemented together with peer support to explore the influence of this mode on self-management ability and health outcome of patients with non-proliferative diabetic retinopathy,so as to provide clinical nursing reference for helping patients change their health concepts,shape their health behaviors and delay the progression of disease.MethodsPatients with non-proliferative diabetic retinopathy from 2022.01 to 2022.10 in the endocrinology department of a tertiary hospital in Hohhot,Inner Mongolia were selected as the research subjects.One of the wards of the endocrinology department was randomly selected as the intervention group and the other as the control group by tossing a coin,and 36 subjects were randomly selected from the patients who met the inclusion and exclusion criteria.The two groups were given traditional care,and the intervention group was given nursing intervention based on IKAP theory combined with peer support.Both groups completed the general information questionnaire,diabetic retinopathy patient selfmanagement scale,diabetic life quality-specific scale and diabetic retinopathy-related knowledge questionnaire within 3 days of admission;three months after discharge,the data were collected again through outpatient follow-up or by clicking the link or scanning the QR code through the "Questionnaire Star" APP on We Chat platform.The statistical software of SPSS25.0 was used to evaluate and analyze data.Results1.Before intervention,there was no statistical difference in the general information between the two groups of patients(P>0.05),which was comparable.2.Comparison of self-management ability between the two groups: Before intervention,there was no statistical significance in diet rule,symptom management,emotion management,exercise,eye management,blood glucose monitoring score and total score of ability between the two groups(P>0.05),indicating comparability.After intervention,the scores and total scores of all dimensions of self-management ability in the intervention group were higher than those in the control group,with statistical difference(P<0.05).3.The self-management ability of the two groups was compared within the group: After intervention,the total scores of diet rule,exercise,eye management,blood glucose monitoring and self-management ability of the control group were higher than before intervention,but there was no statistical significance(P>0.05).The total score of self-management ability and scores of each dimension in the intervention group were significantly higher than before intervention,with significant differences(P<0.05).4.Comparison of quality of life between the two groups: Before intervention,there was no statistical significance in physiological,psychological,social,therapeutic scores and total scores of quality of life between the two groups(P>0.05),indicating comparability.After intervention,the scores and total scores of all dimensions of quality of life in the intervention group were lower than those in the control group,with statistical difference(P<0.05).5.The quality of life of the two groups was compared within the control group: In the control group,there was no statistical significance in social relationship scores before and after intervention(P>0.05),but there were significant differences in physiological,psychological and therapeutic scores(P<0.05).In the intervention group,the scores and total scores of all dimensions of quality of life were significantly different before and after intervention(P<0.05).6.The mastery of disease knowledge was compared between the two groups: There was no significant difference in the diabetic retinopathy knowledge between the two groups before intervention(P>0.05).After intervention,the correct rate of the intervention group was significantly higher than that of the control group(P<0.05).7.Repeated measurement of physiological indicators between the two groups: The mean values of FPG、2h PG、Hb A1 c in the two groups showed a decreasing trend because of the prolongation of time,and there were significant differences at three different measuring time points(F=18.269,P<0.001;F=26.922,P<0.001;F=108.441,P<0.001).There was an interaction between time point and group(F=3.520,P<0.05;F=8.444,P<0.05;F=15.224,P<0.001),indicating that the effect of time factors changed with different groups.The two groups were compared at 3 different time points respectively,and there was no significant difference between the two groups before intervention and at the time of discharge(P>0.05).After intervention,the control effect of FPG,2h PG and Hb A1 c in the intervention group was more advantageous than that in the control group,with statistical difference(P<0.05).8.Visual acuity changes of patients in both groups before and after intervention: After intervention,the rate of visual acuity decline was 5.88% in the intervention group and 19.44%in the control group.But there was no significant difference in visual acuity between the two groups(P<0.05).Conclusion1.The self-management ability,quality of life and disease knowledge of the non-proliferative diabetic retinopathy patients were at a low to medium level.2.The nursing intervention based on IKAP theory combined with peer support can improve the self-management ability and disease knowledge mastery of the non-proliferative diabetic retinopathy patients,strengthen correct beliefs,promote healthy behaviors and reverse clinical outcomes.3.The nursing intervention based on IKAP theory combined with peer support can improve the health outcome of the non-proliferative diabetic retinopathy patients,delay the progression of the disease and reduce the rate of blindness.