ABSTRACT
Objective To evaluate the effect of managed health education on psychological and nutritional status of patients with HBV-related cirrhosis and ascites.Methods One hundred and twenty one patents with decompensated HBV-related cirrhosis were enrolled for health education and randomly divided into two groups:61 patients received managed health education (trial group) and 60 received conventional health education (control group).In control group patients were informed with their condition and diet note by medical orders.In control group the hepatologists evaluated the baseline condition,nutritional status and quality of life,set up personal files of patients and followed up with communication and counselling periodically from June 2010 to August 2012.The psychological conditions were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS) ; nutritional status was assessed with triceps skinfold thickness (TSF) and mid-arm muscle circumference (MAMC) and the quality of life was assessed with MOS 36-item shoort from healthy survey (SF-36).Results Before health education,there was no statistical difference in the scores of SAS,SDS,TSF,SF-36 and blood Hb,albumin (Alb) levels between two groups.After health education,scores of SAS and SDS were decreased in both groups (P ＜ 0.0l),however,which in trial group were lower than those in control group (39.9 ±8.8 vs.49.0 ±9.4 and 40.6 ± 8.8 vs.51.9 ± 10.1 respectively,both P ＜0.01).The TSF scores and blood Hb and Alb levels in trial group were higher than those in control group (P ＜ 0.05).The accunulated scores of 8 dimensions in SF-36 forms in trial group were significantly higher than those in control group (P ＜ 0.01).Conclusion The managed health education model can better release psychological pressures,decrease mental disorders,elevate nutrition status,promote health and improve quality of life than conventional health education for patients with HBV-related cirrhosis and ascites.
ABSTRACT
A questionnaire and telephone survey was conducted on 246 patients with chronic liver diseases in the Outpatient Clinic from August 2010 to May 2011.The distribution of diseases and the causes of losing follow-up were analyzed. Most subjects in this survey (182/246,74.0％ ) were patients with chronic viral hepatitis( HBV or HCV)and cirrhosis; and their follow-up status was better than others (X2 =12.382,P ＜ 0.05). There were no differences in gender( X2 =10.137,P ＞ 0.05),but significant differences in age ( X2 =31.783,P ＜ 0.05 ) and educational levels ( X2 =32.803,P ＜ 0.05 ) between patients with chronic viral hepatitis and cirrhosis and patients with other liver diseases.The main causes of losing follow-up were neglect of disease by patients (38.3％) and lack of good communication between doctors and patients ( 18.3％ ).It is important to reinforce the understanding and awareness of chronic liver diseases for patients.