Department of Medicine, Jefferson Einstein Hospital, Philadelphia, USA.
Jefferson Einstein Hospital, Thomas Jefferson University, 5501 Old York Road, Klein 505, Philadelphia, PA, USA.
Dig Dis Sci. 2024 Dec;69(12):4364-4372. doi: 10.1007/s10620-024-08704-2. Epub 2024 Nov 7.
Current evidence shows limited patient understanding of liver disease, coupled with no standard guidelines or methods to offer patient education in a busy clinical environment. We developed multimedia-based education (MBE) for those with cirrhosis & tested its effectiveness in improving patient knowledge from baseline to 1 month.
This prospective study enrolled cirrhotic patients who had a scheduled visit with a hepatologist at an ambulatory academic practice or were admitted to the liver inpatient service. Once consented, patients completed a baseline knowledge questionnaire, and were given a link to watch the videos (text or email). Four videos were developed by the study team with input from clinicians and patients (liver function, symptoms and complications, medical management and preventive actions & nutrition). At month 1, the study coordinator confirmed with the patient that they had watched the videos at least once, and patients completed the same knowledge questionnaire. The scores between pre- and post-intervention were compared using the Wilcoxon signed rank test.
Of the 120 enrolled, 113 completed baseline and 75 completed follow-up. 48% had alcohol-related liver disease as the underlying cause of cirrhosis. Mean MELD score at enrollment was 14.7 ± 8.14. There was a statistically significant improvement in knowledge scores across all domains from baseline to month 1 (p < 0.05). The overall knowledge score improved from 65 to 83% (p < 0.001), with highest improvement by 40% in the domain of liver function and causes of cirrhosis.
MBE can help improve patients' knowledge about liver function, management, and prevention and can be used in both ambulatory and inpatient hepatology practice.
目前的证据表明,患者对肝脏疾病的理解有限,而且在繁忙的临床环境中,没有标准的指南或方法为患者提供教育。我们为肝硬化患者开发了基于多媒体的教育(MBE),并测试了其在 1 个月内提高患者知识的效果。
这项前瞻性研究纳入了在门诊学术实践中与肝病专家预约就诊或住院的肝硬化患者。一旦获得同意,患者完成基线知识问卷,并获得观看视频的链接(文本或电子邮件)。研究小组由临床医生和患者共同开发了 4 个视频(肝功能、症状和并发症、医学管理和预防措施以及营养)。在第 1 个月,研究协调员与患者确认他们至少观看了一次视频,患者完成了相同的知识问卷。使用 Wilcoxon 符号秩检验比较干预前后的评分。
在 120 名入组的患者中,113 名完成了基线调查,75 名完成了随访。48%的患者肝硬化的潜在病因是酒精相关肝病。入组时的平均 MELD 评分为 14.7±8.14。从基线到第 1 个月,所有领域的知识评分均有统计学显著改善(p<0.05)。知识总评分从 65%提高到 83%(p<0.001),肝功能和肝硬化病因领域的提高幅度最高,达到 40%。
MBE 可以帮助提高患者对肝功能、管理和预防的知识,可用于门诊和住院的肝病实践。