Effect of Implementing a Discharge Plan on Knowledge and Self-care performance among Patients with Esophageal Varices Post Endoscopic Band Ligation.

Abstract

Background: Esophageal varices (EV) are serious complications of portal hypertension, commonly resulting from liver cirrhosis, and a leading cause of life-threatening gastrointestinal bleeding worldwide. In Egypt, EV prevalence is high due to liver diseases such as viral hepatitis and schistosomiasis. Endoscopic variceal ligation (EVL) is the standard treatment; however, patients remain at risk for rebleeding and variceal recurrence. Effective discharge planning is essential to promote self-care, ensure continuity of care, and prevent complications. Aim: This study aimed to evaluate the effect of a structured discharge plan on knowledge and self-care performance among patients with EV following EVL. Methods: A quasi-experimental design was conducted at the Gastrointestinal Endoscopy Unit of Alexandria Main University Hospital. Sixty adult patients undergoing EVL were randomly assigned to either a study group (n = 30) receiving a structured discharge plan or a control group (n = 30) receiving routine care. Data were collected using two researcher-developed tools: a knowledge questionnaire on EV and post-ligation care, and a self-care performance checklist covering dietary practices, medication adherence, lifestyle modifications, recognition of warning signs, and follow-up behaviors. The discharge plan included individualized teaching sessions, illustrated handouts, and follow-up guidance delivered before discharge and reinforced during post-discharge visits. Results: Baseline demographic and clinical characteristics were similar between groups. Post-intervention, the study group showed significant improvement in overall knowledge (from poor to 100% good knowledge at 1 month) and all domains of self-care performance compared to the control group (p < 0.001). Knowledge retention and self-care behaviors were maintained over time in the study group, while the control group showed declining scores. Conclusion: Implementation of a structured discharge plan significantly improves knowledge and self-care performance among patients with EV post-EVL, supporting better disease management, reduced complications, and decreased hospital readmissions. Recommendations: Hospitals should implement nurse-led discharge programs, and future research should explore long-term and technology-assisted interventions to further enhance patient outcomes