Relationship Between Quality of Life and an Educational Strategy Based on the Information Needs of Patients With Liver Cirrhosis
DOI:
https://doi.org/10.22516/25007440.1368Keywords:
Quality of life, liver cirrhosis, caregiver burden, health educationAbstract
Introduction: Implementation of educational strategies in patients with liver cirrhosis has been shown to improve quality of life. However, these results may not be generalizable to all populations, as information needs vary according to sociodemographic characteristics, cultural factors, and specific determinants of health-related quality of life (HRQoL). The aim of this study was to evaluate the relationship between an educational strategy—designed based on previously identified local needs—and quality of life in a population of patients with cirrhosis.
Methods: A prospective, longitudinal, analytical study was conducted at a second-level outpatient center specializing in chronic liver diseases in Cartagena (Gastropack S. A. S.). All adult patients diagnosed with liver cirrhosis who attended in May 2024 were included. The intervention consisted of providing written informational materials about cirrhosis and its complications, supplemented by synchronous virtual sessions conducted by a hepatology specialist, followed by a final Q&A session. After signing informed consent, patients completed the Chronic Liver Disease Questionnaire (CLDQ), and caregivers completed the Zarit Burden Interview before and after the intervention, administered by a trained interviewer.
Results: Forty patients were included, with one excluded due to death during follow-up. 64% (n = 25) were female. At the conclusion of the intervention, the CLDQ score increased by an average of 29 points (95% CI: 24–34; p < 0.001), representing a 21.8% improvement from baseline, and caregiver burden decreased by 46%.
Conclusion: An educational strategy incorporating written materials and virtual sessions significantly improved patient quality of life and reduced caregiver burden in individuals with chronic liver disease.
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Riley TR, Smith JP. Preventive care in chronic liver disease. J Gen Intern Med. 1999;14(11):699-704. https://doi.org/10.1046/j.1525-1497.1999.11188.x
Yepes Barreto I, Lepesqueur Guillen L. Predictores de calidad de vida en pacientes con enfermedad hepática crónica en Colombia. Rev Colomb Gastroenterol. 2016;30(4):390. https://doi.org/10.22516/25007440.2
Labenz C, Toenges G, Schattenberg JM, Nagel M, Huber Y, Marquardt JU, et al. Health-related quality of life in patients with compensated and decompensated liver cirrhosis. Eur J Intern Med. 2019;70:54-9. https://doi.org/10.1016/j.ejim.2019.09.004
Rabiee A, Ximenes RO, Nikayin S, Hickner A, Juthani P, Rosen RH, et al. Factors associated with health-related quality of life in patients with cirrhosis: a systematic review. Liver Int. 2021;41(1):6-15. https://doi.org/10.1111/liv.14680
Yanny B, Pham NV, Saleh H, Saab S. Approaches to Assessing Burden in Caregivers of Patients with Cirrhosis. J Clin Transl Hepatol. 2020;8(2):127-134. https://doi.org/10.14218/JCTH.2019.00054
Hyland ME, Jones RCM, Hanney KE. The Lung Information Needs Questionnaire: Development, preliminary validation and findings. Respir Med. 2006;100(10):1807-16. https://doi.org/10.1016/j.rmed.2006.01.018
Abdi F, Daryani NE, Khorvash F, Yousefi Z. Experiences of Individuals With Liver Cirrhosis: A Qualitative Study. Gastroenterology Nursing. 2015;38(4):252. https://doi.org/10.1097/SGA.0000000000000122
Yepes-Barreto I, Londoño JP, Mejía P. Necesidades de información de los pacientes con cirrosis hepática y calidad de vida. Rev Colomb Gastroenterol. 2024;39(1):14-28. https://doi.org/10.22516/25007440.1062
Burnham B, Wallington S, Jillson IA, Trandafili H, Shetty K, Wang J, et al. Knowledge, Attitudes, and Beliefs of Patients with Chronic Liver Disease. Am J Health Behav. 2014;38(5):737-44. https://doi.org/10.5993/AJHB.38.5.11
Zandi M, Adib-Hajbagheri M, Memarian R, Nejhad AK, Alavian SM. Effects of a self-care program on quality of life of cirrhotic patients referring to Tehran Hepatitis Center. Health Qual Life Outcomes. 2005;3:35. https://doi.org/10.1186/1477-7525-3-35
Ferrer M, Córdoba J, Garin O, Olivé G, Flavià M, Vargas V, et al. Validity of the Spanish version of the Chronic Liver Disease Questionnaire (CLDQ) as a standard outcome for quality of life assessment. Liver Transplantation. 2006;12(1):95-104. https://doi.org/10.1002/lt.20551
Rodríguez ÁPA, Córdoba AMC, Poches DKP. Escala de sobrecarga del cuidador Zarit: estructura factorial en cuidadores informales de Bucaramanga. Revista de Psicología Universidad de Antioquia. 2016;8(2):87-99. https://doi.org/10.17533/udea.rpsua.v8n2a06
Hayward KL, Valery PC, Patel PJ, Horsfall LU, Wright PL, Tallis CJ, et al. Effectiveness of patient-oriented education and medication management intervention in people with decompensated cirrhosis. Intern Med J. 2020;50(9):1142-6. https://doi.org/10.1111/imj.14986
Verma M, Chan M, Toroghi S, Gallagher M, Lo K, Navarro V. Multimedia-Based Education Led to Improvement in Disease Knowledge Among Patients with Cirrhosis. Dig Dis Sci. 2024;69(12):4364-72. https://doi.org/10.1007/s10620-024-08704-2
Orman ES, Ghabril MS, Desai AP, Nephew L, Patidar KR, Gao S, et al. Patient-Reported Outcome Measures Modestly Enhance Prediction of Readmission in Patients with Cirrhosis. Clin Gastroenterol Hepatol. 2022;20(6):e1426-37. https://doi.org/10.1016/j.cgh.2021.07.032
Kok B, Whitlock R, Ferguson T, James Bailey R, Warren Burak K, Kowalczewski J, et al. Health-Related Quality of Life: A Rapid Predictor of Hospitalization in Patients With Cirrhosis. Am J Gastroenterol. 2020;115(4):575-83. https://doi.org/10.14309/ajg.0000000000000545
Ramachandran J, Woodman RJ, Muller KR, Wundke R, McCormick R, Kaambwa B, et al. Validation of Knowledge Questionnaire for Patients With Liver Cirrhosis. Clin Gastroenterol Hepatol. 2020;18(8):1867-1873.e1. https://doi.org/10.1016/j.cgh.2019.11.045
Kim YJ, Soeken KL. A Meta-Analysis of the Effect of Hospital-Based Case Management on Hospital Length-of-Stay and Readmission. Nursing Research. 2005;54(4):255. https://doi.org/10.1097/00006199-200507000-00007
Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M, Haywood P, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev. 2003;(1):CD001117. https://doi.org/10.1002/14651858.CD001117
Bloom PP, Che Z, Hyde A, Johnson E, Miguel-Cruz A, Carbonneau M, et al. Development and Evaluation of a Patient Cirrhosis Knowledge Assessment. Dig Dis Sci. 2024;69(2):399-409. https://doi.org/10.1007/s10620-023-08238-z
Nagel M, Weidner V, Schulz S, Marquardt JU, Galle PR, Schattenberg JM, et al. Continued alcohol consumption and hepatic encephalopathy determine quality of life and psychosocial burden of caregivers in patients with liver cirrhosis. Health Qual Life Outcomes. 2022;20(1):23. https://doi.org/10.1186/s12955-022-01923-z
Burke T, Hardiman O, Pinto-Grau M, Lonergan K, Heverin M, Tobin K, et al. Longitudinal predictors of caregiver burden in amyotrophic lateral sclerosis: a population-based cohort of patient-caregiver dyads. J Neurol. 2018;265(4):793-808. https://doi.org/10.1007/s00415-018-8770-6
Shrestha D, Rathi S, Grover S, Taneja S, Duseja A, Chawla YK, et al. Factors Affecting Psychological Burden on the Informal Caregiver of Patients With Cirrhosis: Looking Beyond the Patient. J Clin Exp Hepatol. 2020;10(1):9-16. https://doi.org/10.1016/j.jceh.2019.06.002
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