The effect of tailored nursing interventions based on the IKAP model on the discharge readiness of the spouses or children of breast cancer patients: a randomized controlled trial.
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BACKGROUND: Breast cancer is distressing as it affects the whole family. During the course of anti-tumor treatment, it plays a role of crucial significance of the patient's discharge and subsequent home rehabilitation. The home-based rehabilitation of patients after discharge during anti-tumor treatment is closely associated with the matter of whether the next treatment cycle can be initiated smoothly. Nevertheless, the majority of patients and their caregivers are ill-prepared when confronted with multiple requirements, problems, and complex information. OBJECTIVE: This research aims to investigate the application efficacy of the nursing intervention based on the IKAP model in the discharge readiness of the spouses or children of breast cancer patients, thereby providing a reference basis for clinical nurses to establish a discharge health education intervention model for them. METHODS: This research was a randomized controlled trial. From July 2024 to November 2024, 100 spouses or children of breast cancer patients in the Oncology department of a Grade-A tertiary hospital in China were selected and split into an intervention group and a control group(n = 50 each). The control group received routine health education during hospitalization. The intervention group, after routine education, implemented IKAP-based nursing intervention (info collection, cognitive ed., belief support, behavior int.). Data on discharge readiness, disease uncertainty of caregivers, and patients' quality of life in both groups were collected and analyzed by MMRM at pre-intervention (usually 2nd day after admission), discharge, 3, 6, 9, and 12 weeks. RESULTS: The IKAP-based nursing intervention had a significant positive effect on breast cancer patients' spouses/children, with a significant time interaction effect between groups (P < 0.001). From 3-12 weeks post-intervention, the intervention group's caregivers had a significantly higher discharge readiness score (3 weeks: 3.89, 95% CI (2.36, 5.44); 12 weeks: 7.09, 95% CI (5.55, 8.64)) and a significantly lower disease uncertainty score (3 weeks: -6.42, 95% CI (-10.12, -2.72); 12 weeks: -15.46, 95% CI (-19.18, -11.73)). From 6-12 weeks post-intervention, the intervention group's breast cancer patients had a significantly higher quality of life score (6 weeks: 9.62, 95% CI (4.01, 15.22); 12 weeks: 15.58, 95% CI (9.96, 21.19)). The intervention effects of the three indicators improved with increasing intervention time. No adverse events were noted during the study. CONCLUSION: IKAP-model-based nursing intervention can significantly raise the discharge readiness level of spouses or children of breast cancer patients, reduce their disease uncertainty, and effectively improve the quality of life of breast cancer patients.