Application of whole-closed-loop nursing model of “Integration of medical and nursing care-quaternary linkage” in decompensated patients with hepatitis B liver cirrhosis

Abstract

BACKGROUND Due to the long course of decompensated hepatitis B liver cirrhosis and the shortage of hospital beds, most of such patients need to receive medical care at home or in the community or elderly care center after their condition is stable. Therefore, an integrated care model involving the hospital, community, family, and institution is essential to the recovery of patients. AIM To evaluate the effect of the whole- closed-loop nursing model of “integration of medical care and nursing care-quaternary linkage” in patients with decompensated hepatitis B liver cirrhosis. METHODS This study is a single-center, prospective, randomized controlled study. The subjects of the study were 100 decompensated patients with hepatitis B cirrhosis who were discharged from the hospital after completing the in-hospital treatment from July 2019 to July 2020. They were randomized into either a routine care group (50 cases) or a novel care group (50 cases). The routine group received routine continuation care, and the novel care group implemented the whole-closed-loop nursing model of “integration of medical care and nursing care-quaternary linkagents”. The medication compliance and complications of the two groups were recorded, and changes in emotional state, social support, disease uncertainty, quality of life, and self-management behavior were observed before and 3 mo after the intervention. RESULTS The overall medication compliance rate of the novel care group (98.00%) was significantly higher than that of the routine care group (84.00%), and the complication rate (10.00%) was significantly lower than that of the routine care group (26.00%) (P < 0.05). The scores of stress-anxiety, depression-frustration, confusion-confusion, anger-hostility, and fatigue-sluggishness on the Profile of Mood States scale were lower, and the energy-vitality score was significantly higher in the novel care group than in the routine care group (P < 0.05). SSRS and WHOQOL-BREF scores as well as the scores of each dimension of the self-management behavior scale were significantly higher in the novel care group than in the routine care group, and the MUIS-A score was significantly lower than that of the routine care group (P < 0.05). CONCLUSION The whole-closed-loop nursing model of “integration of medical and nursing care-quaternary linkage” is highly feasible for decompensated patients with hepatitis B cirrhosis, and it is conducive to improving patient medication compliance, social support, mood state, and self-management behavior, reducing disease uncertainty, improving quality of life, and reducing complications.