Therese Marie Golingay Donnelly, DNP, FNP-C

Abstract:

Problem Statement: Non-alcoholic fatty liver disease (NAFLD) is rapidly increasing in health and economic burden and necessitates the introduction of preventive and treatment measures in high-risk subpopulations to reduce NAFLD-related morbidity and mortality. Studies have shown that following a healthier lifestyle, losing weight, and treating individual metabolic syndromes can proactively help prevent, postpone, or reverse liver damage caused by NAFLD.Methods: This scholarly project was a single-group, pre- and post-test pilot quality-improvement study designed to improve our understanding of the findings for 26 participants diagnosed with NAFLD within the past year without recent progression. The focus was on lifestyle changes, evidenced by a change in behavior, slowing down the progression of NAFLD to severe liver disease. Eight weekly individual coaching sessions, each lasting 30 to 60 minutes, taught, guided, and supported participants to initiate lifestyle changes in diet and exercise. Individual coaching sessions utilized motivational interviewing, followed by a semi-structured curriculum that included questions designed to elicit participants' responses to inquiries intended to assess their progress. Findings: Study participants were enrolled and underwent baseline measurements. Throughout the course of the study, five subjects dropped out leaving a total of 21participants. The sample's average baseline waist circumference was 41.2 inches (95% CI: 28.8, 54). The final waist circumference measurement was 39.3 (95% Cl: 27.6, 51.1) inches, which displayed a trend in the correct direction. At baseline, individuals weighed 206.5 (141.8–271.1) pounds. The average weight at week eight was 194.8 (95% CI: 133.4, 256.1) pounds. Adjusting for height, individuals' baseline BMI was 34.8 kg/m2 (95% Cl: 26.3, 43.1). The average BMI at week 8 was 32.6 kg/m2 (95% Cl: 23.7, 41.4) kg/m2. The three-factor eating questionnaire (TFEQ) is one of the most commonly used instruments to measure dietary restraint characteristics (Stunkard et al., 1985). The TFEQ data suggests a trend toward overall improvement in uncontrolled eating behaviors, cognitive restraint, and emotional eating behaviors. Conclusion: Participants on average showed a modest reduction in weight over the intervention period, which suggests that the intervention may have been successful. The waist circumference measurements and data indicate the intervention reduced the waist circumference. The results are not statistically significant with the BMI data suggesting that the intervention contributed to a decreased BMI at the post-intervention visit. However, these findings suggest improvements in NAFLD as well with the emphasis placed on weight-reduction as a principal treatment for NAFLD.

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