Rajpurohit Siddheesh, Musunuri Balaji, Mohan Pooja B, Bhat Ganesh, Shetty Shiran
Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Clin Exp Hepatol. 2024 Sep-Oct;14(5):101433. doi: 10.1016/j.jceh.2024.101433. Epub 2024 Apr 30.
BACKGROUND/AIMS: Health-related quality of life (HRQoL) relates to how people perceive illness and treatment affects their physical health, emotional health, functional status, and social position. Along with clinical goals, HRQoL is significant. Therefore, the present study evaluates the effect of patient counseling and education on HRQoL of cirrhotic patients.
This prospective study was conducted in a tertiary care center of coastal Karnataka, Kasturba Medical College, Manipal, Karnataka from October 2022 with a three-month follow-up. Patients with a confirmed diagnosis of liver cirrhosis visiting the outpatient department of age ≥18 were enrolled in the study and divided on the basis of compensated and decompensated cirrhosis. Patients were randomized into two groups i.e., case and control in compensated and decompensated group through the envelop method of randomization. The case group received patient education and counseling along with standard medical therapy. CLDQ was used to evaluate HRQoL scores on baseline and after the third month.
A total of 104 patients were enrolled with a mean age of 53.49 ± 11.25, with most being male (80.7%). Out of 104, 60 and 44 had compensated and decompensated cirrhosis. Case and control groups did not differ significantly on baseline. However, on follow-up, the compensated group showed significant improvement in abdominal symptoms, fatigue, and emotional functions. Meanwhile, the decompensated group showed significant improvement in activity, emotional function, and worry domain of CLDQ. Higher MELD scores were the significant factor associated with lower HRQoL scores.
Patient education and counseling positively impacted the fatigue, emotional, and worry domain of the CLDQ. Hence, the present study recommends making an effort to promote patient counseling and education via leaflets or videos.
背景/目的：健康相关生活质量（HRQoL）关乎人们如何看待疾病及治疗对其身体健康、情绪健康、功能状态和社会地位的影响。除临床目标外，HRQoL也很重要。因此，本研究评估患者咨询与教育对肝硬化患者HRQoL的影响。
本前瞻性研究于2022年10月在卡纳塔克邦沿海地区的三级医疗中心马尼帕尔卡斯图尔巴医学院开展，并进行了为期三个月的随访。确诊为肝硬化且年龄≥18岁的门诊患者纳入本研究，并根据代偿期和失代偿期肝硬化进行分组。通过随机信封法将代偿期和失代偿期组的患者随机分为两组，即病例组和对照组。病例组在接受标准药物治疗的同时接受患者教育与咨询。使用CLDQ在基线和第三个月后评估HRQoL评分。
共纳入104例患者，平均年龄为53.49±11.25岁，大多数为男性（80.7%）。104例患者中，60例为代偿期肝硬化，44例为失代偿期肝硬化。病例组和对照组在基线时无显著差异。然而，在随访中，代偿期组在腹部症状、疲劳和情绪功能方面有显著改善。同时，失代偿期组在CLDQ的活动、情绪功能和担忧领域有显著改善。较高的MELD评分是与较低HRQoL评分相关的显著因素。
患者教育与咨询对CLDQ的疲劳、情绪和担忧领域产生了积极影响。因此，本研究建议通过传单或视频努力促进患者咨询与教育。
