Objective:

To examine the effect of continuity care guided by Information–Knowledge–Attitude–Practice (IKAP) theory on symptom management in patients with chronic obstructive pulmonary disease (COPD) and on caregiver burden.

Approach:

• Study Design: A retrospective controlled study involving 300 COPD patients discharged from one hospital, assigned to routine care or IKAP-based continuity care.
• Intervention: The intervention group received structured measures including information collection, knowledge delivery, attitude reinforcement, individualized exercise prescriptions, and caregiver training for 6 months.
• Outcome Measures: Outcomes included caregiver burden, COPD-related health status, disease-specific quality of life, disease knowledge level, medication adherence, and self-care ability, assessed at multiple time points.

Key Findings:

• The intervention group had higher rates of nursing contact and continuity achievement compared to the control group (P < 0.001).
• Caregiver burden (ZBI-22) and COPD-related health status (CAT) scores were significantly lower in the intervention group at T1–T3 (all P < 0.001).
• SGRQ total scores improved in the intervention group, with a total score of 43.4 ± 10.9 at T3 compared to 60.3 ± 11.7 in the control group (P < 0.001).
• Knowledge levels increased from < 20% at T0 to 58.0% at T3 in the intervention group (P < 0.001).
• Medication adherence increased from < 30% at baseline to 64.0% at T3 in the intervention group, while no improvement was observed in the control group.
• Self-care ability (ESCA scores) reached 122.1 ± 10.2 at T3 in the intervention group compared to 95.0 ± 8.1 in the control group (P < 0.001).

Interpretation:

IKAP-based continuity care was associated with reduced caregiver burden and improved patient outcomes including symptoms, quality of life, knowledge, medication adherence, and self-care ability.

Limitations:

• The study design was retrospective and controlled, which may limit the generalizability of the findings.
• The study was conducted in a single hospital, which may not represent broader populations.

Conclusion:

IKAP-based continuity care shows promise in managing COPD by improving both patient and caregiver outcomes.