Objective To investigate the impact of health education based on the LEARNS framework on the psychological state, nutritional status, and treatment adherence of patients with liver cirrhosis complicated with upper gastrointestinal bleeding. Methods A prospective study design was adopted. A total of 98 patients diagnosed with liver cirrhosis combined with upper gastrointestinal bleeding hospitalized at the Second Affiliated Hospital of Zhengzhou University from April 2023 to April 2025 were enrolled and randomly assigned to the conventional group (routine health education, n＝49) and the research group (health education guided by the LEARNS framework, n＝49). During the research, 2 patients in the conventional group were lost to follow-up and another 2 withdrew voluntarily; in the research group, 1 patient was lost to follow-up, 2 violated the intervention protocol, and 1 received major treatment adjustment. The final valid sample consisted of 45 cases in each group. The psychological status, nutritional indicators and treatment compliance behaviors were compared between the two groups. Results After intervention, the Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale-17 (HAMD-17) scores of the research group were significantly lower than those of the conventional group (all P＜0.05). The subscale scores of the treatment compliance scale, as well as levels of transferrin (TRF), prealbumin (PAB), albumin (ALB), body weight and total skeletal muscle mass were markedly higher in the research group (all P＜0.05). Conclusion Health education constructed under the LEARNS framework can effectively improve psychological conditions, strengthen patients’ treatment adherence, and optimize nutritional status in patients with liver cirrhosis complicated with upper gastrointestinal bleeding, which is worthy of clinical popularization.