First Advisor

Melissa Henry

First Committee Member

Carolyn Bottone-Post

Second Committee Member

Michael Kriss

Third Committee Member

Laura K. Stewart

Degree Name

Doctor of Nursing Practice

Document Type

Scholarly Project

Date Created

12-2024

Department

College of Natural and Health Sciences, Nursing, Nursing Student Work

Abstract

Non-alcoholic fatty liver disease (NAFLD), now known as metabolic dysfunction-associated steatotic liver disease (MASLD), is the leading cause of chronic liver disease in the world. The mechanisms involved in its development and progression continue to be a mystery that scientists are trying to unravel. However, many research studies found a correlation between uncontrolled obstructive sleep apnea (OSA) and worsening of NAFLD. Chronic intermittent hypoxia and sleep fragmentation in OSA increase sympathetic activity and promote oxidative stress, pro-inflammatory cytokine production, and metabolic dysregulation, which increases the risk of various diseases, including NAFLD/MASLD progression. Early assessment and screening for OSA in patients diagnosed with NAFLD and patient education by primary care providers on adhering to treatment modalities to control OSA are the keys to combating this global disease. Primary care providers are in constant contact with patients diagnosed with NAFLD. However, despite the high prevalence and growing burden of NAFLD, most of them are unaware or have limited knowledge of this critical OSA-NAFLD correlation and might not be assessing, screening, educating, and treating their NAFLD patients properly.

The purpose of this project was to evaluate if an evidence-based educational intervention delivered to primary care providers improved their awareness, knowledge, attitudes, and intention to change practice about screening patients with NAFLD for the presence of OSA and to provide improved patient education about this phenomenon. This purpose was answered in conjunction with the following project question:

Q1 Will an evidence-based educational intervention delivered to primary care providers improve their awareness, knowledge, and intention to increase screening and change clinical management of obstructive sleep apnea (OSA) among patients also diagnosed with nonalcoholic fatty liver disease (NAFLD)?

With the application of the knowledge, attitude, and practice model in conjunction with the Continuing Professional Development-Reaction Questionnaire, a pre-posttest design with a synchronous in-person educational intervention based upon the integrated literature review discussed the NAFLD-OSA phenomenon. The evidenced-based intervention was delivered to Northern Colorado Nurse Coalition members at a regional meeting. Fifteen advanced practice RNs completed the pre-post survey via Qualtrics Survey. The survey response demonstrated increased awareness, knowledge, attitude, and intention to change practice about assessing and screening patients with NAFLD for the presence of OSA and to provide improved patient education about the phenomenon after the educational intervention. Like previous findings, few advanced practice providers knew of the correlation between uncontrolled OSA and worsening of NAFLD before the education intervention, highlighting the need for continuous professional development provided through this doctoral scholarly project to improve patient outcomes.

Abstract Format

html

Disciplines

Nursing | Nutritional and Metabolic Diseases | Sleep Medicine | Vocational Education

Keywords

Cirrhosis; Continuous Positive Airway Pressure (CPAP); Non-Alcoholic Fatty Liver Disease (NAFLD); Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD); Obstructive Sleep Apnea (OSA); Intermittent hypoxia; Chronic intermittent hypoxia; Primary care providers; Reactive oxygen species; Oxidative stress

Language

English

Places

United States of America

Rights Statement

Default

Digital Origin

Born digital

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