Garrido Maria, Turco Matteo, Formentin Chiara, Corrias Michela, De Rui Michele, Montagnese Sara, Amodio Piero
Department of Medicine, DIMED, University of Padova, Padova, Italy.
BMJ Open Gastroenterol. 2017 Sep 11;4(1):e000161. doi: 10.1136/bmjgast-2017-000161. eCollection 2017.
Providing structured information for the understanding of hepatic encephalopathy (HE) might be relevant to the prevention and management of the syndrome. The aim of our study was to design a brief, structured educational intervention and evaluate its usefulness in preventing HE-related hospitalisation over time.
Thirty-nine cirrhotic outpatients with a history of HE were enrolled and randomly assigned to an intervention (group A; n=20) or control group (group B; n=19). All of them underwent evaluation of HE (clinical and quantitative neuropsychiatric assessment) and completed the Questionnaire on the Awareness of Encephalopathy. A 15 min educational session was then provided to patients in group A, including basic information on the pathophysiology, hygienic and medical management of HE.
No demographic/clinical differences were observed at baseline between the two groups. Similarly, there were no significant differences in HE-related information available at baseline between the two groups; knowledge of HE was limited in both. The intervention was highly effective in increasing patients' understanding of treatment of the condition (from 5% to 80%). The educational intervention also reduced the risk of developing an episode of HE over a period of 12 months.
The educational intervention confirmed the poor knowledge of patients with previous HE about their condition, served as a tool to increase patients' awareness, and minimised HE-related readmission rates over a period of 1 year.
提供结构化信息以助于理解肝性脑病(HE)可能与该综合征的预防和管理相关。我们研究的目的是设计一种简短的结构化教育干预措施,并评估其在长期预防与HE相关的住院方面的有效性。
招募了39名有HE病史的肝硬化门诊患者,并将其随机分为干预组(A组;n = 20)或对照组(B组;n = 19)。所有患者均接受了HE评估(临床和定量神经精神评估),并完成了脑病认知问卷。然后为A组患者提供了一个15分钟的教育课程,内容包括HE的病理生理学、卫生和医疗管理的基本信息。
两组在基线时未观察到人口统计学/临床差异。同样,两组在基线时可获得的与HE相关的信息也没有显著差异;两组对HE的了解都很有限。该干预措施在提高患者对该病治疗的理解方面非常有效(从5%提高到80%)。教育干预还降低了12个月内发生HE发作的风险。
教育干预证实了既往有HE的患者对其病情了解不足,是提高患者意识的一种手段,并在1年内将与HE相关的再入院率降至最低。