Application of continuous care based on IKAP theory in patients with diabetic macular edema

Why This Matters for People with Diabetes

For many people living with diabetes, the first real warning sign that something is wrong with their eyes can arrive too late—when reading, driving, or recognizing faces starts to become difficult. This study looks at a simple but powerful question: can structured, ongoing support after hospital treatment help people with diabetic macular edema not only see better but also live better? By following patients for several months, the researchers tested a new style of follow-up care designed to teach, encourage, and guide patients in everyday life, long after they leave the clinic.

The Eye Problem Behind Blurred Central Vision

Diabetic macular edema is a common eye complication of diabetes and a leading cause of vision loss in working-age adults. High blood sugar over time damages tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye. When these vessels leak, fluid collects in the macula—the area that provides sharp central vision—causing swelling and blurred sight. Modern drugs that are injected into the eye and block a molecule called VEGF are now the standard treatment, but they must be given repeatedly over months or years. This demands money, time, and emotional resilience from patients, many of whom know little about the disease or how to care for themselves between visits.

A New Way to Stay Connected After Leaving the Hospital

To tackle these challenges, the research team in Weifang, China, built a “continuous care” program rooted in a health-education model known as Information–Knowledge–Attitude–Practice (IKAP). Instead of stopping support at discharge, nurses and doctors formed a dedicated team that followed patients home through regular phone calls, in-person visits, and a WeChat group on their smartphones. They first collected basic information and assessed how much each patient understood about diabetes, eye disease, and daily habits. Then they delivered tailored lessons on topics such as medication use, diet, exercise, eye care, and blood sugar monitoring using short videos, demonstrations, and simple explanations adjusted to each person’s age and education level.

Helping Patients Feel In Control, Not Overwhelmed

The care did not stop at information. Many patients with diabetic macular edema feel anxious about losing their sight and about the cost and discomfort of repeated eye injections. The IKAP model addresses these feelings directly. Nurses offered relaxation and music sessions, encouraged patients to share their stories, and invited family members into the conversation. Doctors answered questions about treatment to build trust and reduce fear. Patients were urged to help shape their own care plans, and success stories from peers with improved vision were shared online. This combination of emotional support and practical guidance was intended to shift patients’ attitudes—from passive worry to active engagement—and to turn new attitudes into daily habits.

What Changed in Daily Habits and Vision

To test the impact of this approach, 130 patients receiving eye injections for diabetic macular edema were randomly divided into two groups. Both groups received standard discharge instructions, but only one group received the extra IKAP-based continuous care for three months. Before and after the program, the researchers measured how patients viewed their illness, how well they managed their diabetes (including diet, exercise, medication, and blood sugar checks), and how their vision-related quality of life changed, using well-known questionnaires. They also tracked actual changes in visual acuity—the ability to read smaller lines on an eye chart—classifying results as improved, stable, or worse.

Clearer Vision and Better Quality of Life

After three months, the group receiving continuous IKAP-based care reported a more balanced and less fearful view of their disease. They scored higher in all aspects of self-care, from healthy eating and exercise to blood sugar monitoring and foot care. Perhaps most importantly for patients, more eyes in this group showed improvement or stability in vision compared with the routine-care group, and scores describing how well people functioned in everyday activities—such as reading, moving around independently, and social interactions—were higher. In plain terms, structured, ongoing support helped people understand their condition, stick to healthy routines, and preserve their sight.

What This Could Mean for Future Eye Care

The study suggests that for people with diabetic macular edema, success is not just about what happens in the operating room or injection room, but also about what happens at home every day. A relatively simple program that blends clear information, emotional support, and practical coaching—delivered through a mix of face-to-face encounters and smartphone communication—can make a meaningful difference in both vision and quality of life. Although the research was done in a single hospital over only three months, it points to a future in which long-term eye care for people with diabetes routinely includes continuous, personalized support beyond the clinic walls.

Citation: Wang, H., Li, H., Wang, Y. et al. Application of continuous care based on IKAP theory in patients with diabetic macular edema. Sci Rep 16, 8633 (2026). https://doi.org/10.1038/s41598-026-39981-8

Keywords: diabetic macular edema, diabetes eye care, continuous nursing, patient self-management, vision quality of life