Dissertation committee:
Μπροκαλάκη Ηρώ, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ, Επιβλέπουσα
Ελευσινιώτης Ιωάννης, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Φώτος Νικόλαος, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Καλοκαιρινού Αθηνά, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Φιλντίσης Γεώργιος, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Γιαννακοπούλου Μαργαρίτα, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Κατσούλας Θεόδωρος, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction: Liver cirrhosis (LC) is a chronic disease with serious complications deteriorating patients' quality of life (QoL) and leading to significant burden on healthcare system. Insufficient adherence of patients to treatment recommendations, is considered a major factor of inefficacious disease management.
Aim: To evaluate the effect of educational intervention on adherence to treatment recommendations in patients with LC.
Methods: This was a case-control interventional study, involving cirrhotic patients who were followed up at the outpatient hepatology department of a general hospital of Athens, from January 2015 to September 2018. The educational intervention consisted of one session supported by a nurse along with a specific information leaflet. Data were collected at patients’ initial evaluation and subsequently at 3 and 6 months. Adherence was estimated by specific scales such as A-14 and QoL by the Chronic Liver Disease Questionnaire (CLDQ). Statistical analysis was performed with the SPSS 22.0 statistical program. The level of statistical significance was set at 0.05.
Results: 125 patients participated in the study of whom 65 were included in the intervention group and 60 in the control group. Patients’ mean age in the intervention group was 66.5 years (SD=11.8), while patients’ mean age in the control group was 64.2 years (SD=13.7). Educational intervention led to statistically significant improvement in adherence to treatment recommendations, and this effect was maintained during the 6-month follow-up period (p<0.001). Additionally, educational intervention improved the overall QoL (p<0.001) and reduced the proportion of patients with at least one readmission as well as the total number of readmissions (p<0.001) during the 6-month follow-up period. Multivariate analysis showed that the effect of educational intervention on patient adherence to treatment recommendations and QoL, were independent from patients’ demographic and clinical characteristics.
Conclusions: Education is an emerging and important nursing intervention for improving both LC patients' adherence to treatment recommendations and QoL.
