| Objective:(1)To investigate the health education needs of liver transplant patients in different periods and establish a suitable health education pathway for liver transplant patients.(2)The liver transplant health education pathway will be applied to the clinic,evaluate its intervention effect on self-care ability,the incidence of complications after liver transplantation,the re-admission rate of liver transplant patients within 3 months after discharge,the immunosuppressive drugs adherence of liver transplant patients between the 3months after discharge from the hospital.Methods:This study is divided into two parts.The first part:using semi-structured interviews,literature review and expert consultation methods,according to the health education needs of different stages of liver transplant patients during perioperative period,establish a suitable health education pathway for liver transplant patients during perioperative period and carry out preliminary experiments to modify and improve its contents.The second part:from September 2017 to December 2018,a total of 76 patients who underwent DCD liver transplantation for the first time in the liver transplantation center of a top-three hospital in Changchun City,Jilin Province were conveniently selected.38 patients with DCD liver transplantation from September 2017 to April 2018 were selected as the control group,38patients with DCD liver transplantation from May to December 2018 were selected as the test group.The control group was used the routine health education and the test group was used the health education pathway based on the health needs of liver transplant patients.Comparing the differences of groups in the self-care ability level,the incidence of postoperative complications,the readmission rate within 3 months after discharge,and immunosuppressive medication adherence after 3 months,simultaneously analysis influencing factors of self-care ability of liver transplant patients.The data were analyzed by IBM SPSS24.0.The statistical methods included mean plus or minus standard deviation,t-test,c~2 test,analysis of variance and multi-factor linear regression.When P<0.05,the difference between the two groups was statistically significant.Results:A total of 73 liver transplant patients completed the study,including 36 in the control group and 37 in the test group.(1)Baseline data:there was not statistically significance between the test group and the control group in gender,age,occupation,place of residence,education level,family monthly income,marital status,type of medical insurance,the time of illness,and the access to knowledge(P>0.05).(2)Comparison of self-care ability:before the intervention,the average score of self-care ability of the control group was(95.83±7.28)and the average score of self-care ability of the test group was(96.70±6.52),there was no significant difference between the two groups(P>0.05).After the intervention,the average score of self-care ability of the control group was(112.11±7.60),the average score of self-care ability of the test group was(128.86±6.18).Compared with the two groups,the self-care ability of the test group was higher than that of the control group,the difference was statistically significant(P<0.05).The changes of self-care ability after intervention in the two groups:the difference of self-care ability before and after the intervention of the test group was(32.70±9.14)and the difference of self-care ability before and after the intervention group was(16.28±10.85).The difference of the test group was higher than that of the control group,the difference was statistically significant(P<0.05).(3)Comparison of the incidence of complications after liver transplantation:the incidence of postoperative complications was 33.33%in the control group and 13.51%in the test group.The difference between the two groups was statistically significant(P<0.05).(4)Comparison of the re-admission rate of liver transplant patients within 3 months after discharge:in the control group,the re-admission rate was 25.00%due to infection fever,rejection and pleural effusion within 3 months after discharge.In the test group,the re-admission rate was 5.41%due to fever,rejection and pleural effusion within 3 months after discharge.The difference between the two groups was statistically significant(P<0.05).(5)Comparison of the immunosuppressive drugs adherence of liver transplant patients between 3 months after discharge from the hospital:in the control group,the adherence rate of immunosuppressive drug was 69.44%between 3 months after discharge and the adherence rate of the immunosuppressive drug in the test group was 89.19%.The difference between the two groups was statistically significant(P<0.05).(6)Multi-factor analysis of influencing factors of self-care ability:analysis showed that income,type of payment,time of illness,education level and occupational factors were independent influencing factors of self-care ability.Conclusions:This study established a suitable health education pathway for liver transplant patients during the perioperative period.The health education pathway which is based on perioperative needs of liver transplant patients can improve the self-care ability of liver transplant patients,reduce the incidence of complications after liver transplantation,effectively reduce the re-admission rate of liver transplant patients within 3 months after discharge and improve the immunosuppressive drugs adherence of liver transplant patients. |
