Abstract:
Malnutrition is common among patients with end stage liver disease including
liver cirrhosis and liver cancer. Optimal nutrition is important to reduce morbidity and mortality of these
patients. There is limited qualitative data on nutritional status and management of chronic liver disease
patients. We aimed to explore the knowledge, opinions and practices of cirrhosis patients and health
workers in nutritional management of cirrhosis in Ghana, in order to determine whether there is a need
to improve nutritional care for cirrhosis patients.
Methods: We conducted a qualitative study using semi-structured interviews of cirrhotic patients
(n ¼ 16) and healthcare providers (n ¼ 27) in three academic centers in Accra, Kumasi and Cape Coast
(Ghana). Recruitment was by purposive sampling of patients attending specialist liver disease clinics. The
recorded data were analyzed using NVivo 11 software, with generation of codes, themes and subthemes.
Results: The major themes that emerged from the data included nutrition as part of care delivery during
the hospital visit, nutritional recommendations, dietary changes and long-term practice improvement.
The results showed that patients and health workers felt dietary recommendations for patients were
frequently addressed, but could be significantly improved. We found that in the opinion of study participants,
local guidelines are important and necessary in nutritional management of cirrhosis patients,
and that participants felt it was difficult to change dietary habits following cirrhosis diagnosis.
Conclusions: These results suggest that nutritional management of cirrhosis patients in Ghana requires
improvement. Strategies to improve this could include a multi-disciplinary approach to nutritional
management, development of local guidelines and continued nutritional assessment, monitoring and
follow-up.
