关键词: 肝移植；自我管理；格林模式；方案构建

Abstract: Objective: To develop and evaluate a PRECEDE-PROCEED model-based self-management program for liver transplant recipients to improve their self-management and quality of life. Methods: The program was developed using the PRECEDE-PROCEED model, literature review, and qualitative interviews, then finalized through two rounds of Delphi consultation. A total of 73 patients from a tertiary grade A hospital in Qingdao were enrolled. Those transplanted from June to November 2023 received standard care (control group). Those transplanted from December 2023 to May 2024 received the intervention. Outcomes (self-management, quality of life, medication adherence, and unplanned readmissions) were assessed at discharge, 3 months, and 6 months. Results: Response rates of two rounds consultation were 84.21% and 100.00%. Kendall's W were 0.358 (P<0.001) and 0.368 (P<0.001), showing strong consensus. The final program included three domains, 9 themes, and 27 measures. Significant group-by-time interactions were found for self-management, adherence, and quality of life (all P<0.05). Unplanned readmissions were lower in the intervention group (P<0.05). Conclusion: The PRECEDE-PROCEED model-based program improves self-management, quality of life, and reduces readmissions in liver transplant recipients.

Key words: liver transplantation; self-management; PRECEDE-PROCEED model; scheme construction