Comprehensive Interventions in HBV Care: Nursing-Sensitive Approach.

Abstract

Objectives: The objective of this study was to evaluate the impact of a comprehensive intervention using nursing-sensitive quality indicators on pregnant women with hepatitis B and their newborns.

Design: A randomized controlled monocentric trial was conducted from January 2020 to May 2022. Participants/Materials: 80 pregnant women diagnosed with hepatitis B were randomly assigned to either a control group (n = 40) or an experimental group (n = 40). The experimental group received care-sensitive quality indicators during treatment.

Setting: This study was conducted in the Department of Traditional Chinese Medicine, Nantong Third People's Hospital, affiliated with Nantong Hospital 3 of Nantong University, Jiangsu, China.

Methods: Participants in the experimental group received daily tenofovir from late pregnancy to early postpartum, and newborns received hepatitis B vaccine and immunoglobulin within 24 h of birth. Healthcare personnel underwent 6 months of training on care-sensitive quality indicators. The effectiveness of the intervention was assessed using various indicators such as health education coverage, antiviral medication compliance, follow-up rates, and psychological health.

Results: The results showed that after comprehensive intervention, the coverage rate of health education increased from 82.50% before intervention to 92.50% (p = 0.033), and adherence to antiviral medication improved from 82.50% to 97.50% (p = 0.000). The follow-up rate for hepatitis B mothers also significantly increased from 80.00% to 95.00% (p = 0.001). In addition, the incidence of negative emotions such as anxiety and depression among pregnant women significantly decreased from 57.50% to 30.00% (p = 0.000). These findings demonstrate the effectiveness of comprehensive interventions in improving health education coverage and participation, enhancing adherence to antiviral medication, and effectively reducing the psychological burden of pregnant women. Moreover, after the intervention, the awareness of mother-to-child transmission prevention for hepatitis B significantly increased from 82.36 points before intervention to 94.32 points after intervention (p = 0.000). At the same time, adherence to neonatal immunization increased from 80.00% to 95.00%, and satisfaction with nursing services improved from 90.66 points to 98.64 points (p = 0.000). These results indicate that comprehensive interventions significantly enhance knowledge related to mother-to-child transmission prevention, increase immunization adherence, and improve satisfaction with nursing services.

Limitations: The study's limitations include a small sample size and a single-center location, which may affect the generalizability of the results. Future research should involve more extensive, multicenter studies to validate the findings.

Conclusions: Comprehensive interventions that incorporate nursing-sensitive quality indicators significantly enhance the effectiveness of prevention strategies for hepatitis B transmission from mother to child. These findings underscore the importance of comprehensive care strategies in improving health outcomes for pregnant women with hepatitis B and their newborns.