In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent ...In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.展开更多
Objective:To develop a self-management behaviour tool for liver cirrhosis patients in China.Methods:A provisional scale comprising 30 items was developed based on the results of literature review,semi-structured inter...Objective:To develop a self-management behaviour tool for liver cirrhosis patients in China.Methods:A provisional scale comprising 30 items was developed based on the results of literature review,semi-structured interviews,expert consultation and pilot study.Patients with hepatic cirrhosis(n=180)from four grade A tertiary hospitals in Tianjin and Handan Infectious Disease Hospital were assessed using the provisional self-management scale comprising 30 items in four dimensions.The reliability and validity of the scale were tested and a final version of the self-management scale for liver cirrhosis comprising 24 items was concluded.Results:The overall Cronbach's a for the scale was 0.80,ranging from 0.60 to 0.69 in each dimension.The testeretest correlation was 0.84,ranging from 0.54 to 0.72 in each dimension.Content validity for the scale was 0.93.Nine factors were extracted by a factor analysis method,which were limited to four factors according to a scree test.The cumulative variance contribution rate was 56.98%.Conclusion:This scale has good reliability and validity and can be used to evaluate selfmanagement behaviour of hepatic cirrhosis patients and provides a reference for behaviour intervention.展开更多
文摘In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.
文摘Objective:To develop a self-management behaviour tool for liver cirrhosis patients in China.Methods:A provisional scale comprising 30 items was developed based on the results of literature review,semi-structured interviews,expert consultation and pilot study.Patients with hepatic cirrhosis(n=180)from four grade A tertiary hospitals in Tianjin and Handan Infectious Disease Hospital were assessed using the provisional self-management scale comprising 30 items in four dimensions.The reliability and validity of the scale were tested and a final version of the self-management scale for liver cirrhosis comprising 24 items was concluded.Results:The overall Cronbach's a for the scale was 0.80,ranging from 0.60 to 0.69 in each dimension.The testeretest correlation was 0.84,ranging from 0.54 to 0.72 in each dimension.Content validity for the scale was 0.93.Nine factors were extracted by a factor analysis method,which were limited to four factors according to a scree test.The cumulative variance contribution rate was 56.98%.Conclusion:This scale has good reliability and validity and can be used to evaluate selfmanagement behaviour of hepatic cirrhosis patients and provides a reference for behaviour intervention.
