The Effect of a Nurse Led Self-Management Enhancing Program on Antiviral Drug Adherence in Patients with Hepatitis B Virus-related Hepatocellular Carcinoma
DOI:
https://doi.org/10.60099/jtnmc.v38i03.261732Keywords:
Nurse led self-management, Antiviral drug adherence, HBV infection, Hepatocellular carcinoma, Hepatitis B antiviral drugAbstract
Introduction Adherence to antiviral drug treatment in patients diagnosed with Hepatitis B virus (HBV)-related hepatocellular carcinoma can effectively decrease the viral load of HBV, resulting in decreased severity and increased survival rate of the patients.
Objective To examine the effect of a nurse-led self-management enhancing program on antiviral drug adherence in patients with HBV-related hepatocellular carcinoma.
Design This study employed a quasi-experimental design with two-group pretest-posttest.
Methodology The sample included 60 patients who were diagnosed with HBV-related hepatocellular carcinoma and were admitted to the medical unit of a tertiary care hospital in Southern Thailand. The sample size was determined using power analysis. The patients were purposively selected based on the inclusion criteria and were then randomly assigned in equal numbers to either the experimental group (n=30) or the control group (n=30). The experimental group received the standard care and a nurse-led self-management enhancing program. The program was guided by the self-management concept developed by Kanfer and Gaelick-Buys and relevant literature reviews, consisting of four major strategies plus eleven sessions and a follow-up period after three months. The strategies included 1) goal setting 2) self-monitoring, 3) self-evaluation, and 4) self-reinforcement. The control group received only the standard care. Three questionnaires were used to collect the data on 1) the personal general information, 2) the clinical symptom, and 3) adherence to antiviral drug treatment. The program content was validated by three experts, resulting in a content validity index of 1.00 for the program and .90 for the antiviral drug adherence form. The reliability of the measures was assessed through test-retest reliability, obtaining an interclass correlation coefficient of 1.00. Data analysis included descriptive statistics, as well as comparison of antiviral drug adherence using Paired t-test and Independent t-test.
Results After participating in the nurse-led self-management enhancing program, the mean score of the adherence rate in the experimental group (M = 95.04, SD = 3.87) was significantly higher than that before the program (M = 82.11, SD = 8.55; t = - 9.324, p<.001). The mean score of the adherence in the experiment group was significantly higher than that of the control group (M = 87.79, SD = 6.04; t = -5.526, p<.001). It can be concluded that the nurse led self-management enhancing program can increase antiviral drug adherence in the patients with HBV-related hepatocellular carcinoma.
Recommendation Nurses can apply the nurse led self-management enhancing program for patients with similar characteristics to this study sample. Encouraging the patients to schedule time for their medication taking as appropriate for their daily routine is a key essential.
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