Beg Sabina, Curtis Sam, Shariff Mohamed
Department of Gastroenterology, West Hertfordshire NHS Trust, Watford General Hospital, Hertfordshire, UK.
Eur J Gastroenterol Hepatol. 2016 May;28(5):582-7. doi: 10.1097/MEG.0000000000000579.
Patients with cirrhosis can contribute significantly to maintaining compensation through simple lifestyle measures. It is, however, unknown whether they possess sufficient knowledge to make informed decisions with regard to their health, with few resources invested in patient education. We aimed to determine the level of knowledge that patients with cirrhosis possess and whether an information leaflet can make a positive impact on this.
We prospectively recruited clinically stable patients with cirrhosis to take part in a preintervention/postintervention study. Thirty-nine patients were recruited either to take part in a telephone-based questionnaire followed by repeating the questionnaire 2 months after receipt of a leaflet or to receive the leaflet directly and complete the questionnaire 2 months later.
The questionnaire demonstrated that baseline knowledge in the study group was poor, with a mean score of 3.4 out of a possible 9 points. There was a statistically significant improvement in the score to 7.5 in those who used the leaflet (Wilcoxon's signed-ranked test, P=0.0006). The mean score achieved by those who received the leaflet directly was 6.8, which is comparable to the scores of patients in the first cohort who read the leaflet and is significantly higher than the scores of the same participants before reading the leaflet (Wilcoxon's rank-sum test, P=0.001).
Our results suggest that patients with cirrhosis lack the knowledge to effectively manage their disease. The introduction of a leaflet resulted in a statistically significant improvement in understanding. Longitudinal studies are required to assess whether such interventions can result in improved clinical outcomes.
肝硬化患者可通过简单的生活方式措施对维持代偿起到重要作用。然而,尚不清楚他们是否具备足够的知识来就自身健康做出明智的决策,因为在患者教育方面投入的资源很少。我们旨在确定肝硬化患者所具备的知识水平,以及一份信息手册是否能对此产生积极影响。
我们前瞻性地招募临床稳定的肝硬化患者参与一项干预前/干预后研究。招募了39名患者,一部分参与基于电话的问卷调查,在收到手册2个月后重复该问卷;另一部分直接收到手册并在2个月后完成问卷。
问卷调查显示,研究组的基线知识水平较差,在满分9分的情况下平均得分为3.4分。使用手册的患者得分在统计学上有显著提高,达到了7.5分(Wilcoxon符号秩和检验,P = 0.0006)。直接收到手册的患者平均得分是6.8分,这与第一组阅读手册的患者得分相当,且显著高于同一参与者阅读手册前的得分(Wilcoxon秩和检验,P = 0.001)。
我们的结果表明,肝硬化患者缺乏有效管理自身疾病的知识。引入一份手册使理解程度在统计学上有显著提高。需要进行纵向研究来评估此类干预措施是否能改善临床结局。