Effectiveness of the IKAP Nursing Mode in Improving the Prognosis of Patients after Spontaneous Pneumothorax Single-Hole Thoracoscopy: Retrospective Study

Abstract

Purpose: This study aimed to evaluate the effectiveness of the information-knowledge-attitude-practice (IKAP) nursing mode in improving the prognosis of patients after spontaneous pneumothorax single-hole thoracoscopy. Methods: A retrospective analysis was conducted on the clinical data of patients with spontaneous pneumothorax who underwent single-hole thoracoscopy from June 2020 to June 2023. Among these patients, 59 received traditional nursing care and 52 received care under the IKAP nursing mode. Data on patient demographics, intraoperative variables, rehabilitation time, complications, adverse events, pain scores, quality of life, psychological status, and sleep quality 72 hours after surgery were collected and compared between the two groups. Results: Compared with the traditional nursing group, the IKAP nursing group exhibited significantly shorter chest tube retention time (55.46 ± 9.26 hours vs. 60.74 ± 10.13 hours; p = 0.005), gas stop escape time (50.92 ± 8.73 hours vs. 55.13 ± 7.68 hours; p = 0.009), and overall hospitalization time (4.15 ± 1.53 days vs. 5.17 ± 2.46 days; p = 0.009); significantly lower rates of pleural infection (1.92% vs. 16.95%; p = 0.008) and bleeding events (1.92% vs. 16.95%; p = 0.008); and lower pain scores at 12 hours (4.56 ± 1.57 vs. 5.19 ± 1.14; p = 0.020) and 72 hours after surgery (2.84 ± 0.48 vs. 3.07 ± 0.45; p = 0.010). The patients under the IKAP nursing care also exhibited statistically significant improvements in somatization (81.72 ± 3.98 vs. 79.53 ± 4.02, p = 0.005) and emotion management (81.14 ± 5.26 vs. 78.10 ± 4.78, p = 0.002) compared with those under traditional nursing. Significantly lower levels of anxiety (10.37 ± 2.21 vs. 11.82 ± 2.53, p = 0.002), depression (9.37 ± 2.06 vs. 10.61 ± 2.35, p = 0.004), and stress (21.68 ± 4.16 vs. 23.54 ± 4.78, p = 0.032) were observed under the IKAP nursing mode compared with those under traditional nursing at 72 hours post-surgery. The IKAP nursing group exhibited better sleep quality as measured by the Pittsburgh sleep quality index (PSQI) score (7.94 ± 1.56 vs. 8.64 ± 1.95, p = 0.041) but longer sleep duration (7.45 ± 1.37 vs. 6.72 ± 1.29, p = 0.005) compared with the traditional nursing group. Conclusion: Compared with traditional nursing, the IKAP nursing mode demonstrated favorable outcomes including shorter rehabilitation times, reduced rates of postoperative complications, and improved pain management, emotion management, and sleep quality. This comprehensive and patient-centered approach shows potential to optimize the postoperative care, outcomes, and overall prognosis of patients undergoing thoracoscopy for spontaneous pneumothorax. Owing to its retrospective nature, the potential for selection bias and confounding variables in this work cannot be discounted. Future prospective studies with large and diverse cohorts are warranted to validate these findings.