{
  "abstract": "Objective: This study aimed to explore the effects of a nursing care bundle combined with a clinical nursing pathway on self-management ability, postoperative biochemical markers, medication adherence, psychological status, and quality of life among liver transplant recipients.\n\nMethods: This study was a single-center, prospective, randomized controlled trial. A total of 103 patients who underwent liver transplantation were initially screened. Three individuals were excluded due to severe postoperative complications (n = 1), incomplete medical records (n = 1), or inability to adhere to follow-up procedures (n = 1). The remaining 100 patients completed follow-up and were randomly assigned in a 1:1 ratio to either the control group (n = 50) or the intervention group (n = 50) using a random number table. The control group received routine perioperative nursing care and standard follow-up after discharge. The intervention group received a structured nursing care bundle integrated with a clinical nursing pathway under the enhanced recovery after surgery (ERAS) framework. Primary outcome included self-management ability [assessed using the Chinese version of the Exercise of Self-Care Agency Scale (ESCA)]. Secondary outcomes included postoperative biochemical indicators at 1 and 6 months after discharge [including fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h-PBG), alanine aminotransferase (ALT), serum creatinine (SCr), total bilirubin (TBil), blood urea nitrogen (BUN), and therapeutic drug concentrations], medication adherence [assessed by the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)], psychological status [measured by the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS)], and quality of life (evaluated using the GQOLI-74 questionnaire).\n\nResults: At both 1 and 6 months following discharge, patients in the intervention group demonstrated better biochemical outcomes, including lower FBG, 2 h-PBG, ALT, SCr, TBil, and BUN levels, as well as more stable drug concentrations compared with the control group (P < 0.05). Furthermore, ESCA scores, BAASIS scores, and GQOLI-74 scores were all higher in the intervention group than in the control group (P < 0.05). SDS and SAS scores were reduced in the intervention group relative to the control group (P < 0.05).\n\nConclusion: The integration of a nursing care bundle with a clinical nursing pathway has a positive effect on improving self-management ability and medication adherence, optimizing postoperative biochemical indicators, alleviating negative emotions, and enhancing quality of life in liver transplant patients.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00423-026-04135-x.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Operating Room Nursing, The Second Affiliated Hospital of Guangxi Medical University, No.166 East Daxue Road, Nanning, 530006 Guangxi Zhuang Autonomous Region China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lili Shi"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhiying Lei"
    },
    {
      "affs": [
        0
      ],
      "name": "She Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qiuyun Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiuli Peng"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiongsheng Mo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cr519j5g7ey9k.bib",
  "cited_by": 0,
  "doi": "10.1007/s00423-026-04135-x",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696597/",
  "id": "cr519j5g7ey9k",
  "issns": [
    "1435-2443",
    "1435-2451"
  ],
  "landing_url": "https://doi.org/10.1007/s00423-026-04135-x",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2746|Enhanced Recovery After Surgery"
    ]
  ],
  "openalex": "W7171536843",
  "pdf_url": "https://europepmc.org/articles/PMC13696597?pdf=render",
  "pmcid": "PMC13696597",
  "pmid": "42928061",
  "published": "2026-07-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cr519j5g7ey9k.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:55Z",
      "native_id": "PMC13696597",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00423-026-04135-x"
    },
    {
      "first_seen": "2026-10-30T12:21:20Z",
      "native_id": "MED:42928061",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928061"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Enhanced Recovery After Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Application of a nursing care bundle combined with a clinical nursing pathway in liver transplantation and its impact on patient self-management: a randomized controlled trial",
  "title_text": "Application of a nursing care bundle combined with a clinical nursing pathway in liver transplantation and its impact on patient self-management: a randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:54Z",
  "url": "https://research.draconitic.com/paper/cr519j5g7ey9k",
  "venue": "Langenbeck's Archives of Surgery",
  "versions": []
}