Clinical practice and research on the psychological cognitive ability under the IKAP model in postoperative flap healing and psychological influencing factors in breast cancer
by Lingli Zhang, Kun Huang, Honglin Du, Chunchun Wu, Binqiong Luo, Xiuqin Yang
Psycho-Oncologie, Vol.19, No.3, 2025;
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Objective: To investigate the impact of psychological cognitive ability on flap healing and psychological factors in postoperative breast cancer (BC) individuals under the Information-Knowledge-Attitude-Practice (IKAP) model. Methods: A total of 123 postoperative BC individuals treated at our hospital between April 2022 and April 2023 were selected for the study. They were randomly assigned into a control group (CG, routine nursing model, n = 61) and an observation group (OG, IKAP model-based psychological cognitive ability intervention, n = 62) using a random number table method. The observation group, on the basis of routine care, combined the IKAP model for psychological and cognitive ability intervention. This included providing personalized health education information, enhancing the patients’ knowledge level, changing their attitudes towards the disease, and promoting the implementation of healthy behaviors through psychological counseling and practical training. The healing rates, healing times, and differences in cognitive ability, psychological status, and quality of life scores before and after the intervention were compared involving the two groupings. The impact of cognitive ability on flap healing and psychological factors was also analyzed. Results: After 2 weeks of intervention, the healing rate in the OG was higher than that of the CG [72.58% (45/62) vs. 54.10% (33/61)] (χ2 = 4.527, P = 0.033). The healing time in the OG was shorter than in the CG, but the difference was not considerable (P > 0.05). After 2 weeks of intervention, the two groups showed differences in their Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scores [(7.73 ± 1.61) vs. (6.08 ± 1.53)], and Functional Assessment of Cancer Therapy-Breast (FACT-B) scores [(92.38 ± 6.43)], with the OG showing more significant improvements (P < 0.05). Compared to the unhealed group, the healed group had higher FACT-Cog and FACT-B scores, and lower HADS scores (P < 0.05). Cognitive ability directly predicted flap healing (β = 0.521, P < 0.001) and also influenced it indirectly through psychological factors (β = 0.537, P < 0.001). The mediating effect of psychological factors accounted for 69.17%, and the direct effect of cognitive ability accounted for 30.65%. This shows that cognitive ability affects flap healing both directly and indirectly through psychological changes. Conclusion: The IKAP model can significantly enhance patients’ cognitive ability and quality of life, shorten healing time, and, through the mediation of psychological factors, further promote flap healing. This provides a new perspective and method for comprehensive rehabilitation in postoperative BC patients.