Evaluating a KAP-Based 4C Continuous Nursing Intervention on Self-Management and Glycemic Control in Patients with Type 2 Diabetes Mellitus
Keywords:
Type 2 diabetes, Knowledge‒attitude‒practice theory, 4C continuous nursing, Blood glucose, Self-managementAbstract
Objective: To examine the effects of a 4C continuous nursing model, grounded in the knowledge-attitude-practice (KAP) framework, on glycated hemoglobin (HbA1c), self-management ability, quality of life, chronic disease resource utilization, and compliance behavior in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 119 patients with T2DM admitted to the General Practice Department of Jingxi People's Hospital between January 2024 and March 2025 were enrolled. Participants were assigned to two groups according to nursing method: the control group (n=59) received routine discharge guidance and follow-up, while the intervention group (n=60) received a 6-month 4C continuous nursing intervention based on the KAP theoretical model. Differences in HbA1c, self-management ability, quality of life, chronic disease resource utilization, and compliance behavior were compared between the two groups. Results: At 3 and 6 months post-discharge, the intervention group demonstrated significantly lower HbA1c levels, higher scores in self-management ability, chronic disease resource utilization, and compliance behavior, and a lower quality of life score compared to the control group, with all differences being statistically significant (P < 0.05). Conclusion: The KAP theory–based 4C continuous nursing model can effectively improve glycemic control, enhance self-management ability and compliance behavior, promote efficient use of chronic disease resources, and contribute to quality of life in patients with T2DM, offering a valuable nursing strategy for long-term disease management.
References
Chinese Diabetes Society. (2025). Guidelines for the prevention and treatment of diabetes in China (2024 edition). Chinese Journal of Diabetes, 17(1), 16–139.
Ji, H., Meng, L., Wu, N., et al. (2022). Analysis of the prevalence of chronic complications and blood glucose control in elderly diabetic patients in Baize. Diabetes New World, 25(12), 190–194.
Peng, C., Hong, Y., Liang, C., et al. (2023). Influencing factors and nursing strategies of self-management ability of patients with type 2 diabetes mellitus. Jilin Medicine, 44(6), 1622–1624.
Anon. (2025). Construction and application of health education intervention program for patients with minor stroke based on information-knowledge-belief-behavior theory. Chinese Journal of Modern Nursing, 31(9), 1234–1238.
Fan, J., Wu, X., Xiao, P., et al. (2025). Application of 4C continuous nursing model based on internet platform in family enteral nutrition of patients with gastric cancer after operation. Postoperative and Enteral Nutrition, 32(2), 101–106.
Wang, J., & Chen, S. (2025). Application of continuous 4C nursing combined with health education in elderly patients with coronary atherosclerosis. Heilongjiang Medicine, 49(6), 750–753.
Diabetes Branch of Chinese Medical Association. (2021). Guidelines for the prevention and treatment of type 2 diabetes in China (2020 edition). Chinese Journal of Diabetes, 13(4), 315–409.
Wan, Q., Shang, S., Lai, X., et al. (2008). Reliability and validity of self-management behavior scale for patients with type 2 diabetes mellitus. Chinese Journal of Practical Nursing, 24(7), 26–27.
Zhong, H., Fan, L., Shao, Y., et al. (2014). Reliability and validity analysis of the Chinese version of the chronic disease resource questionnaire applied to patients with diabetes. General Practice of China, 2014(23), 2778–2782.
Li, Y., Wang, Y., Xie, C., et al. (2025). Application of multidisciplinary collaboration model in elderly patients with type 2 diabetes. International Journal of Geriatrics, 46(3), 330–335.
Wang, D., Jin, P., & Yang, J. (2025). Application of information closed-loop health education based on team management model in patients with type 2 diabetes. International Journal of Nursing, 44(8), 1481–1485.
Zhang, Y. (2024). Evaluation of the application effect of WeChat follow-up of community nurses in self-management ability of patients with type 2 diabetes mellitus. Shanghai Pharmaceutical, 45(8), 55–58.
Chen, Y., Lin, Y., Tang, D., et al. (2025). Effect of peer support on health education for elderly patients with type 2 diabetes. New World of Diabetes, 28(10), 152–156.
Zhang, Y., Xiao, J., Liu, X., et al. (2025). The effect of group nursing based on psychological capital intervention model on blood glucose, psychological state and quality of life in elderly patients with type 2 diabetes in community. Practical Hospital Clinical Journal, 22(1), 156–160.
Yan, H. (2025). Effect of case nursing combined with all-media health education on blood glucose control and health behavior in newly diagnosed type 2 diabetic patients. New World of Diabetes, 28(4), 134–137.
Li, Y., Yang, Z., Qin, L., et al. (2025). Application of patient navigation mode in continuous nursing of elderly diabetic patients. Chinese Journal of Modern Nursing, 31(2), 239–243.
Wang, M., Qiao, X., & Zhao, S. (2022). Effect of continuous 4C nursing on self-care ability and compliance behavior of patients with coronary heart disease. Heilongjiang Medicine, 46(21), 2673–2675.
Zhang, Q., Wang, H., Zhang, Y., et al. (2022). The effect of continuous nursing based on 4C model on postoperative compliance, quality of life and visual acuity in patients with diabetic retinopathy. Hebei Medicine, 44(21), 3352–3354.
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Copyright (c) 2026 Chunfeng Huang, Yufang Lu, Haixia Tan
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