Published online Oct 27, 2026. doi: 10.4240/wjgs.122147
Revised: July 8, 2026
Accepted: July 27, 2026
Published online: October 27, 2026
Processing time: 130 Days and 17 Hours
Promoting evidence-based practice and quality improvement based on the indivi
To explore implementation strategies for evidence-based practice and quality improvement based on IFSMT in chronic disease management for older patients at high risk of gastrointestinal bleeding, thereby providing a reference for chronic disease management programs for such patients and improving their prognosis.
A total of 150 older patients at high risk of gastrointestinal bleeding who were admitted to the Department of General Medicine, Affiliated Hospital of Nantong University, from January 2022 to January 2025 were enrolled and randomly divided into two groups using a random number table method. The control group (n = 75) received routine chronic disease management, while the observation group (n = 75) received a continuous quality improvement model of evidence-based chronic disease management based on IFSMT. Self-management ability, health behaviors, psychological status, rebleeding rate, and other indicators were compared between the two groups.
After the intervention, the score of the Self-Management Ability Scale-Short Form in the observation group was 73.51 ± 5.20, which was higher than 68.73 ± 5.16 in the control group. The anxiety and depression scores were lower in the observation group than in the control group. The medication compliance score was 7.10 ± 0.48 in the observation group, which was higher than 6.38 ± 0.51 in the control group. Disease uncertainty and family self-burden were lower and health management behaviors were better in the observation group (P < 0.05). After 12 months of follow-up, the rebleeding rate in the observation group was 1.33%, which was significantly lower than the rate of 10.67% (8/75) in the control group (P < 0.05).
Establishing an IFSMT-based continuous quality improvement model for evidence-based chronic disease management can improve patients' self-management ability, relieve anxiety and depression, enhance medication compliance, and reduce the rebleeding rate. Therefore, this model may be clinically useful.
Core Tip: This study applied an evidence-based chronic disease management quality improvement based on the individual and family self-management theory to 150 older patients at high-risk gastrointestinal bleeding. The model significantly improved patients’ self-management ability and reduced anxiety, depression, and the rebleeding rate, suggesting its clinically valuable.