A study on the application of continuity of care based on the IKAP model in enhancing the self-care ability of children with autism
基于IKAP模式的延续性护理在提升孤独症儿童生活自理能力中的应用研究

摘要

目的 本研究创新性地探索医务人员针对孤独症谱系障碍（ASD）儿童家庭采用基于IKAP模式的延续性护理，规范、科学地对ASD儿童家庭进行专业指导，探讨该模式在提示ASD儿童家庭服务支持和改善ASD儿童生活自理能力的有效性。方法 2024年10月1日-2025年4月1日，选择在我院完成长期班系统培训的ASD儿童34例。由康复治疗师、护士、医生组成干预团队，采用儿童自身前后对照方法，应用IKAP模式的延续性护理对入组儿童进行2次家庭访视巡诊（干预后1个月，干预后3个月）。采用《自制家长对孤独症儿童家庭环境设置及自理能力知信行问卷》评估家属干预前后知信行的得分变化，采用《生活自理能力评估表》，对儿童自理行为进行测评，儿童干预前、干预后1个月、干预后3个月自理能力得分情况，以评价干预的效果。结果 与干预前相比，医疗团队对患者家属进行基于IKAP模式的延续性护理，患者家属的知信行得分均得到改善，P<0.01，差异具有统计学意义。儿童自理能力得分逐步提升，干预后1个月得分稍改善，干预后3个月儿童自理能力提升明显，P<0.01，差异均具有统计学意义。结论 IKAP模式通过阶段性健康教育与技能培训提升家属ASD认知与知识得分，建立医院-家庭联动机制，将理论认知转化为照护实践。该模式通过定期随访中的情景再现与行为矫正解决家庭干预盲点，显著改善ASD儿童生活自理能力，且效果呈时间依赖性。研究表明干预后1-3个月为关键巩固阶段，医务人员居家巡访指导对早期持续性家庭干预具有重要作用，有利于早期居家持续性家庭干预。

Abstract

Objective This study innovatively explored the use of IKAP model-based continuity of care by medical staff for families of children with autism spectrum disorders (ASD) to standardize and scientifically provide professional guidance to families of children with ASD, and explored the effectiveness of the model in promoting the support of services for families of children with ASD and improving the self-care ability of children with ASD.
Methods From October 1, 2024, to April 1, 2025, 34 children with ASD who completed long-term systematic training in our hospital were selected. An intervention team consisting of rehabilitation therapists, nurses, and doctors adopted a self-controlled before-and-after study design and implemented continuous nursing care based on the IKAP model for the enrolled children through two home visits (1 month and 3 months after intervention). The "Self-designed Questionnaire on Parents' Knowledge, Attitudes, and Practices Regarding Home Environment Setup and Self-care Ability of Children with Autism" was used to assess changes in parents' KAP scores before and after the intervention. The "Self-care Ability Assessment Scale" was employed to evaluate the children's self-care behaviors, with scores recorded before the intervention, 1 month after intervention, and 3 months after intervention to assess the intervention's effectiveness.
Results Compared with pre-intervention levels, after receiving continuous nursing care based on the IKAP model from the medical team, the parents' KAP scores showed significant improvement (P<0.01), with statistically significant differences. The children's self-care ability scores gradually increased, showing slight improvement at 1 month post-intervention and marked enhancement at 3 months post-intervention (P<0.01), both with statistically significant differences.
Conclusion   The IKAP model enhances parents' ASD-related cognition and knowledge scores through phased health education and skill training, establishing a hospital-family linkage mechanism to translate theoretical awareness into caregiving practices. By addressing blind spots in home intervention through scenario repetition and behavior correction during regular follow-ups, this model significantly improves the self-care abilities of children with ASD, with effects demonstrating time-dependent progression. The study indicates that the 1–3 month period post-intervention constitutes a critical consolidation phase, during which home visit guidance by medical staff plays a vital role in early sustained family intervention, facilitating long-term home-based care continuity.