Abstract / Summary
Patients with upper gastrointestinal bleeding (UGIB) often experience reduced quality of life, frequent complications, and recurrent hospitalizations, highlighting the need for effective post-discharge support. Telenursing offers a practical strategy to extend nursing care beyond hospital settings and enhance patient self-management through digital communication technologies. To evaluate the effect of a telenursing-based self-care education program on quality of life and patient satisfaction among individuals with UGIB. In this randomized controlled trial, 96 patients with UGIB were allocated to either a telenursing intervention group ( n = 48) or a control group ( n = 48). The intervention combined a self-care mobile application, weekly telephone counseling, and WhatsApp peer support for four weeks. The control group received routine discharge care plus brief weekly telephone follow-up calls intended solely to control for attention received from research staff and maintain comparable participant contact between groups; no structured education, counseling, or digital intervention was provided, and no outcome data were collected from these calls. The primary outcome was quality of life measured using the Gastrointestinal Quality of Life Index (GIQLI). Secondary outcomes included patient satisfaction assessed using the Telenursing Interaction and Satisfaction Questionnaire (TISQ) and mobile application quality assessed using the Mobile Application Rating Scale (MARS). At one month, the intervention group demonstrated significantly higher GIQLI scores than the control group (116.02 ± 15.05 vs. 95.10 ± 13.57; p < 0.001). ANCOVA adjusting for baseline scores confirmed a significant intervention effect (F = 13.38, p = 0.001). Satisfaction scores were significantly better in the intervention group than in the control group (47.04 ± 11.64 vs. 77.39 ± 12.43; p < 0.001). Participants evaluated the mobile application favorably, with a mean MARS score of 98.24 ± 6.54. A structured telenursing program significantly improved quality of life and patient satisfaction during the first month after discharge among individuals recovering from UGIB. Because objective clinical outcomes such as recurrent bleeding, readmission, and mortality were not assessed, the findings should be interpreted as evidence of improved patient-reported recovery rather than confirmed improvement in clinical prognosis. The trial was prospectively registered in the Iranian Registry of Clinical Trials (IRCT) (Registration number: IRCT20201231049897N1; Registration date: 15 January 2021).