Comprehensive analysis of KAP nursing model combined with digital health management on postoperative self-management in BPH patients

Abstract

Background: Benign prostatic hyperplasia (BPH) is common in older men and requires surgical intervention. Optimizing postoperative recovery requires strategies to enhance patient self-management, promote healthy behaviors, and improve QoL. This study evaluated the implications of integrating behavioral nursing theory with digital public health innovation, highlighting its relevance for scalable postoperative care models in aging populations. Methods: A prospective randomized controlled trial, registered at the clinical trial registry (MR-33-2-0766-47), was conducted with 80 postoperative BPH patients undergoing transurethral resection of prostate (TURP). Patients were randomized to an intervention group (n = 40) receiving knowledge, attitude, and practice (KAP)-based nursing plus digital health support, or a control group (n = 40) receiving standard postoperative care. Outcomes (self-efficacy, illness perceptions, health-promoting behaviors, and quality of life) were assessed at baseline, 1 month, and 3 months using the General Self-Efficacy Scale (GSES), Illness Perception Questionnaire (IPQ), Health-Promoting Lifestyle Profile II (HPLP-II), and SF-36 Health Survey. Results: At 3 months post-surgery, the intervention group showed significantly higher GSES scores (32.76 ± 4.12 vs. 27.87 ± 5.12; p = 0.001) and HPLP-II scores (147.76 ± 8.54 vs. 137.98 ± 8.43; p = 0.001) compared to controls, indicating greater self-efficacy and healthier lifestyles. Illness perception improved in the intervention group, with lower IPQ “Consequences” (12.74 ± 2.87 vs. 16.52 ± 3.56; p = 0.002) and “Timeline” scores (11.54 ± 2.43 vs. 14.75 ± 2.65; p = 0.009), and higher “Control/Cure” scores (18.54 ± 4.74 vs. 14.17 ± 2.92; p = 0.001) than controls. SF-36 quality-of-life scores were also better in the intervention group (78.54 ± 6.76 vs. 70.32 ± 8.43; p = 0.001). Postoperative complication rates were lower (10% vs. 25%) and return to normal urination higher (92.5% vs. 60%) in intervention group, with significant difference in normal urination (p = 0.02). Conclusion: Integration of knowledge, attitude, and practice (KAP)-based nursing model with digital health management significantly improved postoperative self-efficacy, fostered healthy lifestyle practices, promoted positive illness perceptions, and enhanced overall QoL in BPH patients. This combined approach highlights the value of structured education and digital support in modern postoperative care. Clinical trial registration: https://register.clinicaltrials.gov/, identifier MR-33-2-0766-47.