Continuous care based on hierarchical nursing for cirrhosis rehabilitation: a retrospective cohort study

Cirrhosis is a progressive chronic liver disease characterized by extensive hepatic fibrosis, portal hypertension, and liver failure. This study aimed to evaluate the associations of continuous care based on hierarchical nursing with the rehabilitation and quality of life of patients with liver cirrhosis.

In this retrospective cohort study, we reviewed the records of 115 patients with liver cirrhosis. Patients who received routine care between August 2022 and July 2023 formed the control group (n = 56), while those who were exposed to continuous care based on hierarchical nursing (implemented as part of standard practice) between August 2023 and July 2024 formed the study group (n = 59).

At 6 and 12 months, both groups showed significant decreases in Model for End-Stage Liver Disease (MELD), Liver Frailty Index (LFI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) from baseline (p < 0.05), with the study group demonstrating lower values than the control group (p < 0.05). Self-management scores, 36-Item Short Form Health Survey (SF-36) scores, and nursing quality increased significantly in both groups over time (p < 0.05), with the study group achieving higher scores (p < 0.05). The study group also exhibited a greater improvement in Child-Pugh grade distribution, a higher nursing satisfaction rate (91.53% vs. 71.43%, p < 0.05), and a lower complication rate (8.47% vs. 25.00%, p < 0.05).

In this retrospective analysis, exposure to continuous care based on hierarchical nursing was associated with superior outcomes compared to routine care, including enhanced quality of life, liver function, self-management, and reduced complications, warranting further prospective validation.