Developing and Evaluating the Effect of Smart Care Model on the Improvement of Physical and Psychological Adaptation among Patients with Moderate to Severe Liver Cirrhosis

Objective: The objective of the three-year study is to develop and evaluate the effect of Self-Management with APP and Reminder Technology (SMART) care model on the improvement of physical and psychological adaptation in patients with moderate to severe liver cirrhosis.Methods: A randomized controlled trial is conducted to examine the effectiveness of SMART care model on the physical and psychological adaptation. A total of 102 patients with moderate to severe liver cirrhosis will be randomly assigned to two groups: intervention group and waiting list group who receiving SMART care and usual care, respectively. Smart care model aimed to conduct individual managements by a self-management APP of liver cirrhosis which provides symptoms monitoring and immediate feedbacks. Outcome measurements are pre-test, after intervention, and at the three and six month after intervention. The instruments include multidimensional symptoms questionnaire, frequency of emergency and outpatient department visit, hospital anxiety and depression scale, and short-form Chinese health-promoting lifestyle profile. Generalized Liner Models（GEE or GLMM）will be used to identify the effectiveness of SMART care model using application of self-management on improving physical and psychological adaptation.Conclusions: The results can identify the benefit of SMART care model in patients with moderate to severe liver cirrhosis. Furthermore, a simple and useful strategy could be better provided to improve physical and psychological adaptation for patients with moderate to severe liver cirrhosis.