Multidisciplinary Integrated Continuous Care in Patients with Liver Cirrhosis

Summary

This study demonstrates that multidisciplinary integrated continuous care improves negative emotions, self-care ability, and quality of life in liver cirrhosis patients compared to routine care.

Abstract

This study aimed to observe the influence of multidisciplinary integrated continuous care on negative emotions, quality of life, and self-care ability in 80 patients with liver cirrhosis (LC) from January 2023 to January 2024. Patients were randomly assigned to group A (n=40, routine care) or group B (n=40, multidisciplinary care). The latter was intervened through the formation of an interdisciplinary team including nutritionists and psychologists, combined with online guidance on the WeChat platform and monthly offline health sharing meetings. Negative emotions (Self-Rating Anxiety Scale [SAS], Self-Rating Depression Scale [SDS]), self-care ability (ESCA), compliance behavior, quality of life (QOL-35), and nursing satisfaction were compared between groups. Results showed that group B had significantly greater reductions in SAS/SDS scores, improved self-care ability, compliance, quality of life, and nursing satisfaction (all P<0.05). Results show that this model can effectively alleviate patients' negative emotions, improve self-management ability and quality of life, and provide an innovative path for the comprehensive care of patients with cirrhosis.

Introduction

Clinically, it is generally considered that the occurrence and progression of liver cirrhosis (LC) are the results of repeated episodes of chronic hepatitis, as well as the liver cell injury, degeneration, and necrosis caused by continuous replication of hepatitis virus-DNA and induction of immune mechanisms in patients. The pathological process will lead to liver cell regeneration, proliferation of fibrous connective tissue, and formation of liver fibrosis, which will eventually develop into LC^1,2. Recent studies indicate that only 50-60% of cirrhosis patients adhere to medication regimens during home care

Protocol

The Institutional Review Board of Tangdu Hospital of the Fourth Military Medical University approved this study (Approval Number: K202405-27). All participants voluntarily participated in the study with full knowledge and signed an informed consent form before the start of the study. The research team explained in detail to the participants the purpose, content, potential risks, and benefits of the study, and clearly informed them that they could choose to withdraw from the study at any stage, and that withdrawal would not have any negative impact on their treatment and medical services.

Included subjects
The study ti....

Results

Comparison of negative emotions
As shown in Table 2, there was no significant difference in SAS and SDS scores between the two groups before nursing (P > 0.05). After nursing, the SAS and SDS scores of Group A significantly decreased (P < 0.001), but the SAS and SDS scores of Group B decreased more significantly and were significantly lower than those of Group A (P < 0.001). The emotional improvement effect of Group B is significantly better than t.......

Discussion

Liver cirrhosis (LC) is a chronic, irreversible liver disease. Progression to the decompensated stage causes severe symptoms, multi-organ involvement, and significant physical and psychological burden on patients. In addition, we are aware of the importance of patients' self-care ability and compliance behavior, which in essence lies in the patients' knowledge about health and active mobilization of subjective initiative. These results align with a study by Zhang et al.¹³, who found multid.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Exercise of Self-care Agency Scale (ESCA)	Kearney & Fleischer	https://psycnet.apa.org/doi/10.1037/t33571-000	43-item scale assessing self-concept, health knowledge, responsibility, and skills.
Quality of Life Scale (QOL-35)	Zhao et al.	10.3969/j.issn.1671-7562.2020.10.026	35-item scale assessing social activities and daily living abilities.
Self-made Assessment Scale for Compliance Behavior	Self-developed	N/A	Assesses diet, tobacco/alcohol control, medication, follow-up, and rest activities.
Self-made Nursing Satisfaction Scale	Self-developed	N/A	Evaluates nursing attitude, skills, and effects (score ≥90: very satisfied).
SPSS 24.0	IBM	Version 24.0	Statistical software for data analysis (t-tests, chi-square tests, etc.).
WeChat	Tencent	https://www.wechat.com/	Online platform for communication and follow-up.
Zung Self-Rating Anxiety Scale (SAS)	Zung	10.1016/S0033-3182(71)71479-0	20-item scale for anxiety assessment (score ≥50 indicates anxiety).
Zung Self-Rating Depression Scale (SDS)	Zung	10.1001/archpsyc.1965.01720310065008.	20-item scale for depression assessment (score ≥53 indicates depression).