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
- 1Department of Operating Room Nursing, The Second Affiliated Hospital of Guangxi Medical University, No.166 East Daxue Road, Nanning, 530006 Guangxi Zhuang Autonomous Region China
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.
Methods: 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).
Results: 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).
Conclusion: 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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00423-026-04135-x.
Related
- A randomized controlled trial of a multidisciplinary collaborative fatigue management program for patients undergoing hematopoietic stem cell transplantation: study protocol
- The effect of pelvic floor muscle exercise, progressive muscle relaxation exercise, and their combined application on comfort in women with stress urinary incontinence: a four-arm randomized controlled trial
- Photobiomodulation versus stabilization splint, both combined with self-management, for acute temporomandibular myalgia: 48-week outcomes of a partially randomized controlled study
- Evaluation of Intraperitoneal Instillation Combined with Port-Site Infiltration of 0.5% Bupivacaine for Postoperative Pain Management in Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Trial
- Preliminary experience with controlled hypothermic storage of donor heart in combined heart transplantation.
BibTeX
@article{shi2026application,
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}},
author = {Lili Shi and Zhiying Lei and She Wang and Qiuyun Huang and Xiuli Peng and Xiongsheng Mo},
journal = {Langenbeck's Archives of Surgery},
year = {2026},
month = jul,
doi = {10.1007/s00423-026-04135-x},
url = {https://doi.org/10.1007/s00423-026-04135-x},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - 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
AU - Lili Shi
AU - Zhiying Lei
AU - She Wang
AU - Qiuyun Huang
AU - Xiuli Peng
AU - Xiongsheng Mo
PY - 2026
DA - 2026/07/29
JO - Langenbeck's Archives of Surgery
DO - 10.1007/s00423-026-04135-x
UR - https://doi.org/10.1007/s00423-026-04135-x
AB - 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. Methods: 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). Results: 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). Conclusion: 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00423-026-04135-x.
SN - 1435-2443
SN - 1435-2451
ER -