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.
Research Article
Multidisciplinary Integrated Continuous Care in Patients with Liver Cirrhosis
In This Article
Summary
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 LC1,2. Recent studies indicate that only 50-60% of cirrhosis patients adhere to medication regimens during home care3.
LC is a long-term and recurrent chronic liver damage disease with persistent and incurable disease, a long course of disease, and many complications, which seriously affect patients' daily lives. Especially when the disease progresses to the decompensated stage, ascites, gastrointestinal bleeding, and other symptoms occur in sequence, aggravating the patient's condition and greatly reducing the survival probability, which leads to a decrease in compliance with medicine and low self-care ability in these patients to varying degrees. Many patients choose home-based treatment due to various factors, and the compliance behavior of patients outside the hospital is significantly decreased, so it is particularly necessary to strengthen the out-of-hospital care for patients with LC3,4. Continuous care is a nursing mode that provides scientific and healthy health protection services to patients receiving home treatment. It has achieved ideal nursing effects in some clinical patients and is an extension of in-hospital care, with high acceptance among many patients. However, previous studies have shown that due to the existence of physiological and psychological adverse phenomena induced by disease factors in patients with LC, single-subject continuous care alone cannot fully meet the needs of patient care2,4.
Recent studies highlight the challenges of managing LC patients' self-care and compliance, underscoring the need for innovative nursing models1,5. Unlike single-subject continuous care, which focuses on isolated medical interventions, multidisciplinary integrated care combines expertise from nursing, psychology, and nutrition to address holistic patient needs, potentially improving compliance and psychological outcomes. To investigate the implementation of a multidisciplinary, integrated, and continuous care model in the treatment of patients with liver cirrhosis (LC), aiming to improve the quality, continuity, and outcomes of patient care5,6. The intervention involved a team of nurses, dietitians, and psychologists providing 12-month follow-ups, including monthly in-person meetings and weekly online guidance. Therefore through observing the application of multidisciplinary integrated continuous care in patients with LC, and analyzing the impact of this model on the negative emotions, quality of life, and self-care ability of patients with LC, this study aims to provide a reference model for the care of patients with LC and related diseases, and improve the overall benefit level of patients.
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 timeline was between January 2023 and January 2024 and included 80 patients with LC. A sample size of 80 (40 per group) was selected based on prior studies7 to ensure sufficient statistical power to detect meaningful differences. The subjects were randomly assigned to group A (n = 40) and group B (n = 40). Patients were randomly assigned using a computer-generated random number table. The balance of two groups of baseline information is ideal (P > 0.05; Table 1).
Entry criteria
Inclusion criteria: The study included patients who met the diagnostic criteria as per the Chinese guidelines on the management of liver cirrhosis8 and confirmed through serological examination, B ultrasonography, and CT. All participants had a clear understanding of the research content.
Exclusion criteria: This study excluded patients with previous autoimmune liver diseases and organic liver diseases, patients with malignant diseases such as liver cancer, patients with diseases of the blood system, heart, brain, and other important organs, and patients with cognitive abnormality or low compliance who failed to cooperate with the research.
Methods
Group A (Conventional nursing): Patients received routine nursing care in the hospital, including disease-related health education, medication management, and dietary guidance. Although the fundamental care procedures were standardized, minor adjustments were made depending on individual patient conditions, such as comorbidities, functional status, or personal preferences. Upon discharge, patients were instructed to attend regular follow-up visits according to their clinical progress and physician recommendations. This care was provided by the hospital's standard nursing team, which consisted of registered nurses (RNs), junior nurses, and health educators. The team was supervised by a senior head nurse with over 10 years of clinical experience. Responsibilities were clearly divided, with RNs primarily handling medication and monitoring, junior nurses assisting with daily care, and educators focusing on patient instructions. All team members had received uniform training in routine liver disease care protocols prior to the start of the study.
Group B (Multidisciplinary integrated continuous care):
Team establishment and clear division of labor: The director of the nursing department took the lead, including a dietician, a psychologist and a specialist nurse: The nursing director served as the group leader, who was responsible for clarifying the responsibilities, process development, standard assessment, supervision, and implementation and evaluation of various work plans for quality control of each member; The nursing members were responsible for the management of WeChat group, establishing two-way relations, and building a continuous nursing platform. The dietician was responsible for nutrition assessment and formulation of nutrition intervention plans, and the psychologist was responsible for assessment and formulation of psychological intervention plans.
Multidisciplinary integrated continuous care plan:
Evaluation: The patients were followed up in the outpatient department on the day of discharge and at 3 months after discharge, and their records were reviewed. The responsible nurse conducts monthly telephone follow-up to evaluate patients' self-concept, health knowledge, and the other four dimensions using the ESCA scale, with each follow-up lasting at least 30 min. An official WeChat account was established, and two popular science articles (including an animated demonstration of the medication process) were shared every week, and a video question and answer (Q&A) meeting was held every month.
Group entry: Patients were assisted in entering the established WeChat group, and its function was explained to them when they were discharged from the hospital.
Online guidance: A public announcement was issued every week in the WeChat group, together with video conferences, time for answering questions and solving new problems on time, and team members were required to evaluate the nutritional status and psychological status of patients in a timely manner.
Health propaganda and education: The patients were handed a printed copy of the general hospital cirrhosis nursing propaganda manual, diet precautions, and daily activities points for attention.
Offline sharing: A monthly gathering of patients in the hospital was organized. A summarizing meeting was held to analyze and summarize the psychological, nutritional, and disease status of patients, and formulate targeted interventions. A schematic diagram of the study design is shown in Figure 1.
Outcome indicators
Negative emotions: The Zung Self Rating Anxiety Scale (SAS)9, Zung Self-Rating Depression Scale (SDS)10 covered 20 items, each item was scored according to no or very little time (1 point), a small part of time (2 points), most of time (3 points), and most or all time (4 points). SDS ≥ 53 points and SAS ≥ 50 points indicated the existence of depression and anxiety. The score was positively correlated with the degree of depression and anxiety of patients.
Self-care ability: The exercise of the self-care agency scale (ESCA)11 included 43 items, including four dimensions of self-concept, health knowledge level, self-care responsibility, and self-care skill, with 172 points. The scores were positively correlated with patients' self-care ability.
Compliance behavior: The self-made assessment scale for compliance behavior included a reasonable diet, control of tobacco and alcohol, correct medication, punctual return visit, and rest activities. The full score of each item was 5 points. The scores were positively correlated with patients' compliance behavior. Compliance behavior was assessed using a self-developed scale, including adherence to diet, medication, and follow-up visits.
Quality of life: The quality-of-life scale (QOL-35)12 included the social activities and daily living ability, with 0-4 points for each item. The score was negatively correlated with patients' quality of life.
Nursing satisfaction: The self-made nursing satisfaction scale included nursing attitude, nursing skill, and nursing effect. The full score was 100 points, with scores ≥ 90 as very satisfactory, 75-89 as satisfactory, and ≤ 74 as unsatisfactory. Total satisfaction = (Very satisfactory cases + Satisfactory cases) /40 100%. The evaluation time was before and after the intervention (3 months after).
Statistical methods
All data are expressed as mean ± standard deviation (Mean ± SD) and are suitable for continuous variables. The categorical variables are expressed in frequency and percentage. An independent sample t-test was used for intergroup comparisons, while a paired t-test was used for intra-group comparisons. For each data set, the normal distribution was tested, and only variables that conform to the normal distribution were subjected to a t-test. If the data does not follow a normal distribution, non-parametric tests such as the Mann Whitney U test should be used. In addition, all count data in the study (such as gender, nursing satisfaction, etc.) were analyzed using chi square test (chi square test). For chi square test, continuity-corrected chi-square test, and Fisher's exact test were used to ensure accurate results when the sample size is small or the frequency is low. All data analyses were conducted using a two-sided test, and P < 0.05 was considered statistically significant. Small p-values <0.001 are reported as "<0.001" for clarity.
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 that of Group A. Before nursing, there was no significant difference in SAS and SDS scores between group A and group B, indicating that the negative emotional levels of the two groups were similar before the start of nursing. However, after nursing, the emotional scores of both Group A and Group B significantly decreased, reflecting the positive effect of nursing intervention. Especially, the SAS and SDS scores of Group B were significantly lower than those of Group A, indicating that the nursing measures of Group B were more prominent in alleviating negative emotions.
Comparison of self-care ability
Before nursing, there was no significant difference in the scores of self-concept, health knowledge level, self-care responsibility, and self-care skills between Group A and Group B (P > 0.05) (Table 3). After nursing, all indicators in Group A and Group B significantly improved, with Group B showing a greater degree of improvement. Especially in terms of self-concept, health knowledge level, nursing responsibility, and skills, Group B scored significantly higher than Group A (P < 0.05), indicating that nursing interventions in Group B are more effective in improving self-care abilities. Although there was no significant difference between Group A and Group B in terms of self-concept, health knowledge level, self-care responsibility, and skills before nursing (P > 0.05), after nursing, Group B scored significantly higher than Group A in all indicators, indicating a difference in the effectiveness of nursing interventions. Especially in terms of self-care skills, the improvement in Group B was significantly greater than that in Group A (P < 0.05). This phenomenon indicates that the nursing methods or interventions in Group B are more effective in enhancing patients' self-care abilities, while Group A, although showing improvement, has relatively less effect.
Comparison of compliance behavior
There was no significant difference between group A and group B in terms of reasonable diet and tobacco and alcohol control before nursing (P > 0.05) (Table 4). After nursing, both groups showed significant improvement in various behaviors (P < 0.001), and the improvement level in group B was significantly higher than that in group A, especially in tobacco and alcohol control. Group A also showed significant improvement, but in comparison, the intervention effect of Group B was more pronounced, demonstrating better compliance and behavioral changes.
Comparison of the quality of life
There was no significant difference in daily living ability and social activities between group A and group B before nursing (P > 0.05) (Table 5). After nursing, both groups showed significant improvements in daily living abilities and social activities (P < 0.001), with Group B showing a significantly higher degree of improvement than Group A, especially in improving daily living abilities, indicating that the nursing intervention effect in Group B was more significant. This indicates that although both groups received nursing interventions, the nursing intervention method of group B may be more effective, resulting in a greater improvement in its various indicators.
Comparison of nursing satisfaction
In the satisfaction evaluation, the overall satisfaction of Group B was significantly higher than that of Group A (100% compared to 80%, P = 0.009) (Table 6). Specifically, 62.5% of participants in Group B expressed 'very satisfied', while only 30% in Group A. Group B did not have any 'unsatisfied' items, while 20% of participants in Group A stated 'unsatisfied'. This indicates that the nursing intervention methods of Group B are more effective in improving patient satisfaction. This difference may be related to the nursing intervention methods of Group A or other factors, such as individual differences.
Figure 1: Schematic of the nursing intervention process used in this study. Please click here to view a larger version of this figure.
Table 1: Comparison of baseline information between groups. The table compares the baseline characteristics of patients in Group A (routine care) and Group B (multidisciplinary continuous care). Variables include gender distribution, age, weight, Child-Pugh classification (assessing liver function), and hepatitis B e-antigen (HBeAg) status. Statistical comparisons were conducted using t-tests, chi-square tests, or rank-sum tests as appropriate. Results show no significant differences between groups (P > 0.05), confirming comparability. Measurements: Age and weight: Mean ± standard deviation (kg, years). Categorical variables (gender, Child-Pugh, HBeAg): Presented as n (%). Statistical significance: P < 0.05 considered significant. Please click here to download this Table.
Table 2: Comparison of negative emotion scores (SAS, SDS) before and after intervention. The table presents pre- and post-intervention scores for the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) in both groups. Group B showed a significantly greater reduction in both anxiety and depression scores compared to Group A (P < 0.001). Measurements: Scores reported as Mean ± SD. SAS and SDS range from 20 to 80; higher scores indicate greater anxiety or depression. Statistical comparison: Paired t-test within groups; independent t-test between groups. Please click here to download this Table.
Table 3: Comparison of self-care ability scores (ESCA Dimensions) before and after intervention. The table compares four dimensions of self-care ability (self-concept, health knowledge level, self-care responsibility, and self-care skills), based on the Exercise of Self-Care Agency (ESCA) scale. Post-intervention, Group B had significantly higher improvements in all dimensions (P < 0.05 or P < 0.001), indicating superior self-care development. Measurements: Mean ± SD, evaluated on ESCA (total score range varies by subscale). Assessed pre- and post-intervention, compared using t-tests. Higher scores indicate better self-care capacity. Please click here to download this Table.
Table 4: Comparison of compliance behaviors before and after intervention. The table details patients' compliance behaviors across six domains: reasonable diet, tobacco/alcohol control, correct medication, punctual return visits, and rest activities. Scores significantly increased post-intervention in both groups, with Group B showing greater gains across all categories (P < 0.001), demonstrating enhanced behavioral compliance under multidisciplinary care. Measurements: Compliance scored from 1 to 5, with higher scores reflecting better adherence. Results shown as Mean ± SD. Comparison within groups via paired t-tests; between groups via independent t-tests. Please click here to download this Table.
Table 5: Comparison of quality of life scores before and after intervention. The table compares scores for daily living ability and social activity before and after the intervention. Group B experienced significantly more improvement in both domains than Group A (P < 0.001), indicating a positive impact of the multidisciplinary care model on patients' quality of life. Measurements: Quality of life assessed using validated subscales (range not specified; lower scores indicate better functioning).Data shown as Mean ± SD. t-tests used for statistical analysis. Please click here to download this Table.
Table 6: Comparison of nursing satisfaction between groups. The table reports nursing satisfaction levels as rated by patients post-intervention. Satisfaction is categorized into very satisfactory, satisfactory, and unsatisfactory. Group B had a significantly higher overall satisfaction rate (100%) compared to Group A (80%) (P = 0.009), indicating greater acceptance and perceived care quality in the multidisciplinary model. Measurements: Satisfaction expressed as n (%). Total satisfaction = very satisfactory + satisfactory. Chi-square test used for group comparison. Please click here to download this Table.
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 multidisciplinary care improved self-management in LC patients, but our study extends this by demonstrating long-term emotional and quality-of-life benefits. An effective nursing model plays an important and positive role in the treatment of patients with LC and the improvement of life quality13,14. In the past, the routine nursing mode only focused on basic routine aspects such as disease cognition propaganda, medication guidance, and ignored the psychological and physiological effects of patients. In addition, the routine nursing mode was limited only to in-hospital guidance, but LC was a chronic disease, and the ideal nursing effect could not be achieved simply by relying on in-hospital guidance. The patients lacked out-of-hospital guidance and management, and were unable to improve their nursing ability and various compliance behaviors. Therefore, it was necessary to explore new nursing modes on this basis, thereby improving the patients' benefits in a planned way15,16.
This study investigated the effectiveness of multidisciplinary continuous care in patient treatment, comparing group A and group B in terms of negative emotions, self-care ability, compliance behavior, quality of life, and nursing satisfaction. The results showed that there was no significant difference in the scores of negative emotions (SAS, SDS) between the two groups before intervention, indicating that the emotional states of the two groups were similar before intervention. However, after nursing intervention, the emotional scores of both Group A and Group B significantly decreased, and the emotional improvement effect of Group B was significantly better than that of Group A, indicating that nursing intervention in Group B is more effective in reducing negative emotions. In terms of self-care ability, there was no significant difference between the two groups before intervention in indicators such as self-concept, health knowledge level, self-care responsibility, and nursing skills. However, after intervention, Group B showed better improvement in all indicators than Group A, especially in the improvement of nursing skills, with Group B showing significantly greater improvement than Group A. This indicates that nursing interventions in Group B are more effective in improving patients' self-care abilities and enhancing their self-management awareness.
In terms of compliance behavior, both groups showed significant improvements in reasonable diet, tobacco and alcohol control, timely medication, and regular follow-up after intervention. The improvement in Group B was generally greater than that in Group A, especially in terms of tobacco and alcohol control and timely medication, with Group B showing the most significant improvement in compliance behavior. Group B's intervention introduced nutritionists, psychologists, and specialized nurses to jointly develop an intervention plan that covers addictive behavior control, motivation stimulation, and behavior correction. And Group B adopts phased follow-up (discharge day+monthly phone call+3-month outpatient follow-up), combined with tools such as the ESCA scale to dynamically evaluate patient behavior execution, which can timely identify weak compliance links and adjust strategies, which is missing in Group A. From the perspective of patients' concepts and attitudes towards treatment, Group B strengthens communication and peer influence among patients through establishing patient self-help groups, holding offline gatherings, and other methods, enabling patients to shift from "passive acceptance" to "active choice" of healthy behaviors, making compliance easier to form and sustain.In terms of quality of life, Group B showed significantly better results than Group A in improving daily living abilities and social activities, indicating that nursing interventions in Group B have a stronger effect on improving patients' quality of life. In terms of nursing satisfaction, the overall satisfaction rate of Group B was 100%, while Group A was 80%, and 62.5% of patients in Group B expressed "very satisfied", significantly higher than Group A's 30%. This indicates that the nursing intervention method of Group B is more successful in improving patient satisfaction. The nursing intervention measures of Group B were significantly more effective than those of Group A in improving patients' emotions, enhancing self-care ability, strengthening compliance behavior, improving quality of life, and increasing patient satisfaction with nursing care.
The results of this study show that multidisciplinary continuous nursing intervention is superior to traditional nursing models in improving the emotions, self-care ability, compliance behavior, quality of life, and nursing satisfaction of lung cancer patients, which is in sharp contrast to previous studies. In previous studies, routine nursing mainly focused on basic nursing guidance during hospitalization, such as disease education and medication instructions, neglecting the psychological support required for long-term chronic disease6,8,12 management and continuous guidance after discharge, making it difficult to effectively improve patients' overall nursing ability and long-term compliance. By introducing a multidisciplinary team and extending nursing services outside the hospital, this study constructed a systematic and sustainable nursing intervention system, which not only significantly improved patients' negative emotions but also significantly enhanced their self-management awareness and life skills. This result validates the effectiveness of the new nursing model in chronic disease management, which has comprehensive advantages over traditional nursing methods and has important clinical promotion value.
Continuous care is a new humanized nursing mode, which is based on the holistic nursing theory and the humanistic care concept. It ensures that after patients are discharged from the hospital, the humanized nursing mode can still be extended to the outside of the hospital, and a standardized and scientific medical service system can be received. It can help medical staff to understand the patients' cognition, medication and awareness of the disease, and cultivate patients' healthy living habits outside the hospital, thereby improving patients' compliance behavior and rehabilitation belief, and accelerating the disease recovery process17,18. Multidisciplinary integration refers to the comprehensive care mode that integrates the respective professional advantages of different specialist members and is conducive to promoting the health of patients19. In this study, patients in the group B had lower SAS, SDS scores, self-concept, health knowledge level, self-care responsibility, self-care skill, reasonable diet, control of tobacco and alcohol, correct medication and punctual return visit score, higher rest activity, daily life ability and social activities score, and better nursing satisfaction in post-nursing, suggesting that the multidisciplinary integrated continuous care was conducive to improving the self-care ability and nursing satisfaction of patients with LC, relieving negative emotions, and strengthening compliance behavior. These results align with prior studies17,22, which showed that multidisciplinary care reduces anxiety and improves self-care in chronic diseases, but extend findings to LC specifically. The reasons for the analysis were as follows: (i) Medical staff constantly explained and answered the related knowledge of LC to patients and their families through LC knowledge promotion fraternity, publicity brochures, to help patients and their families to correctly understand the relevant contents of the disease and improve patients' health knowledge level, which is the basic condition for improving patients' self-care skills20,21. (ii) After discharge, patients can still receive health knowledge propaganda and answer questions from medical professionals through multimedia network channels, so as to ensure their social and psychological adaptation and strengthen their self-care ability in daily life outside the hospital22,23. (iii) The contents, such as psychological support and nutrition intervention, are lacking in the routine nursing mode. Through the multidisciplinary integrated continuous care, the nutritionist among the nursing members can formulate the healthy living behavior which is in line with the patients' own nutrition recovery needs according to the disease situation of the patients, and help the patients to supervise, establish and implement the healthy living habits, which is conducive to improving the compliance behavior and accelerating the patients' recovery; On the other hand, the psychologists within the members timely channel the negative emotions of the patients and their families, encourage their families and the establishment of social support systems, and help patients establish confidence to overcome the disease. This is particularly crucial for improving compliance and negative emotions24,25,26. (iv) The multidisciplinary team continued to provide professional health guidance to the patients outside the hospital. The LC specialists gradually instilled knowledge and self-care skills into the patients, guided the patients to find and actively solve their own problems in daily life, and helped the patients to find the ways and means suitable for them, then confirmed their own efforts and felt the positive results. The psychologists helped the patients to dredge and soothe their emotions from the professional perspective, which was conducive to helping the patients to maintain an optimistic attitude, reduce psychological pressure and relieve bad emotions27,28. (v) Through various channels, multidisciplinary integrated continuous care grasped the situation of patients during home care and maintained information sharing and guidance throughout the process, so that patients and their families could participate, and the non-standardized process details could be guided and corrected, which would help to improve patients' self-care skills and nursing satisfaction29,30.
In summary, the implementation of multidisciplinary integrated continuous care helps relieve patients' negative emotions such as anxiety and depression, enhance patients' self-care ability, improve the quality of life, and ensure the consistency of patients' compliance behavior. It is also of great significance to improve nursing satisfaction, and can be carried out in patients with LC and related diseases to improve the overall benefit level of patients. This study indicates that nursing interventions in Group B have achieved significant effects in multiple aspects, particularly in reducing negative emotions, improving self-care abilities, and improving compliance behaviors. To apply multidisciplinary continuous nursing to clinical practice, it is possible to establish interdisciplinary nursing teams, including psychological care, health education, and behavioral interventions, to provide personalized and continuous nursing support. Adjust the nursing plan in a timely manner by regularly assessing the patient's emotional state, self-care ability, and compliance. At the same time, professional training for nursing staff should be strengthened to enhance their interdisciplinary collaboration abilities, in order to promote the widespread promotion and application of nursing models. This study has limitations, including a single-center design and a small sample size, which may affect generalizability. Although the sample size of this study is based on previous research, it is only 80 cases, which limits the statistical power and representativeness. According to previous research recommendations, the ideal sample size for clinical intervention studies should be ≥ 100 cases to ensure reliability and generalizability. In the future, it is necessary to expand the sample size to validate the robustness of the results2,4,7. Future multicenter studies with larger cohorts are needed to validate these findings. This work extends prior research on multidisciplinary care by demonstrating its specific benefits in LC, providing a replicable model for chronic disease management
In summary, the results of this study indicate that the comprehensive multidisciplinary continuous nursing model has better nursing effects on patients with cirrhosis than conventional nursing. After implementing this model, patients' negative emotions (anxiety and depression) were significantly alleviated, especially in group B, where SAS and SDS scores were significantly reduced. At the same time, the self-care ability, compliance behavior, and quality of life of group B patients significantly improved, and nursing satisfaction was higher. The comprehensive nursing model effectively enhances patients' self-management ability and belief in disease recovery by providing various forms of support, such as psychological counseling, nutritional intervention, etc.
Disclosures
The authors declare that no conflict of interest
Acknowledgements
This study did not receive any funding support.
DATA AVAILABILITY STATEMENT:
All the data of the study are included in the manuscript.
Materials
| 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.). |
| 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). |
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