Development and feasibility evaluation of an educational program to improve health-related quality of life among primary liver cancer patients posttransarterial chemoembolization in Zhengzhou, China

Abstract

Primary liver cancer (PLC) poses a significant health burden globally, with China accounting for over 50% of new cases. Transarterial chemoembolization (TACE) is the standard therapy for intermediate-stage PLC but often leads to adverse effects that severely diminish patients’ health-related quality of life (HRQoL). Despite the central role of nurses in managing these challenges, structured, theory-driven educational interventions targeting HRQoL remain limited in China. This study aimed to develop and assess the feasibility of an educational program to improve HRQoL among PLC patients post-TACE in Zhengzhou, China. Employing a three-phase exploratory sequential mixed-methods design, the study first conducted a systematic review and qualitative interviews to identify key needs and influencing factors. Based on the Health Belief Model, a draft educational program was constructed and refined via two Delphi rounds with multidisciplinary experts. The finalized educational program was then pilot-tested in a one-group pretest-posttest study. HRQoL was measured using the Chinese version of the 36-Item Short Form Health Survey version 2, and paired t-tests were used for data analysis. Findings demonstrated that the educational program effectively addressed symptom burden, emotional distress, and self-management challenges. Participants exhibited significant improvements in both physical and mental HRQoL domains after the educational program (p < 0.05). The program was found to be feasible, well-accepted, and implementable in clinical settings. This research contributes to the field by introducing a structured, evidence- and theory-informed educational program specifically tailored for PLC patients post-TACE. It highlights the critical role of educational programs in supporting patient-cantered care and improving clinical outcomes in oncology nursing. Given the rising prevalence of PLC and growing demand for quality survivorship care in China, the integration of such programs into routine nursing practice may inform institutional policies and guidelines aimed at enhancing cancer care delivery and patient well-being.