The effects of a therapeutic patient education program on the self-care of a patient undergoing hemodialysis

Pipit Lestari, Yulia Yulia

Abstract

Objective: Hemodialysis (HD) can increase risks of health problems, such as fluid and electrolyte imbalances, malnutrition, and sepsis. Self-care is essential to help patients in maintaining fluid balances, enhancing compliance with treatment regimens, and managing psychological problems resulting from HD. Therapeutic patient education (TPE) programs represent an effective nursing intervention to improve patient self-care.

Methods: This is a case report analyzing effects of TPE on self-care in a patient lacking self-care and undergoing HD. The TPE program consisted of five sessions: assessment, motivation, awareness, education and training, and evaluation. The self-care agency scale (SCAS) was used for patient assessment, and program materials were adjusted according to patient needs identified during assessment. Evaluation focused on improving patient knowledge, SCAS score, and interdialytic weight gain (IDWG).

Results: The TPE program increased the patient’s SCAS score by 26%, an IDWG score improvement within the desired limit of 3%–5% of his dry weight was observed, and he was more knowledgeable about each education topic.

Conclusion: TPE is an effective method for increasing the self-care of patients undergoing HD. Our findings suggest that nurses should use TPE programs to improve self-care, enhance treatment compliance, and improve psychosocial well-being among end-stage renal disease (ESRD) patients undergoing HD. Quasi-experimental studies to explore effects of TPE programs on self-care among ESRD patients undergoing HD are required.

Keywords: ESRD, Hemodialysis, IDWG, Indonesia, Nursing Care, Self-care, Therapeutic Patient Education

Full Text:

PDF

References

National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. KIDNEYS. 2016;0(3.17):53.

Perhimpunan Nefrologi Indonesia. 4th Report of Indonesian Renal Registry 2011. Jakarta: PERNEFRI, 2011 [in Indonesia]

Stevens P, O’Donoghue D, Lusignan S De. Chronic Kidney Disease (Ckd) Management in General Practice. Kidney Health Australia [Internet]. 2007 [cited 17/06/2017]. Available from http://kidney.org.au/

Howren MB, Kellerman QD, Hillis SL, Cvengros J, Lawton W, Christensen AJ. Effect of a behavioral self-regulation intervention on patient adherence to fluid-intake restrictions in hemodialysis : a Randomized Controlled Trial. Ann.behav.med. 2016;50:167–176. https://doi.org/10.1007/s12160-015- 9741-0

Mollaog M, Katayas M. Disability is associated with nonadherence to diet and fluid restrictions in end ‑ stage renal disease patients undergoing maintenance hemodialysis. Int Urol Nephrol. 2015;47:1863–1870. https://doi.org/10.1007/s11255-015-1102-1

Chirakarnjanakorn S, Navaneethan SD, Francis GS, Tang WHW. Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations. International Journal of Cardiology. 2017;232:12–23.

Chilcot J, Wellsted D, Farrington K. Illness representations are associated with fluid nonadherence among hemodialysis patients. Journal of Psychosomatic Research. 2010;68(2):203–212. https://doi.org/10.1016/j.jpsychores.2009.08.010

Assimon, MM, Nguyen T, Katsanos SL, Brunelli SM, Flythe JE. Identification of volume overload hospitalizations among hemodialysis patients using administrative claims : a validation study. BMC Nephrology. 2016;1-11.

https://doi.org/10.1186/s12882-016-0384-6

Szuck P, Fuhr LM, Garcia MF, da Silva AT, Wazlawik E. Association between nutritional indicators and risk of hospitalization among hemodialysis patients. Rev.Nutr. 2016;29(3):317–327

Wasse, H. Catheter-Related Mortality among ESRD Patients. Seminars in Dialysis. 2008;21(6):547–549. http://doi.org/10.1111/j.1525-139X.2008.00500.x

Bahadori M., Ghavidel F, Mohammadzadeh S, Ravangard R. The effects of an interventional program based on self ‑ care model on health ‑ related quality of life outcomes in hemodialysis patients. Journal of Education and Health Promotion. 2014;3(110). https://doi.org/10.4103/2277-9531.145899

Rayyani M, Malekyan L, Forouzi MA, Haghdoost A. Self-care Self-efficacy and Quality of Life among Patients Receiving Hemodialysis in South-East of Iran.Asian Journal of Nursing Education and Research. 2014;4(2):165–171.

Idier L, Untas A, Koleck M, Chauveau P, Rascle N. Assessment and effects of Therapeutic Patient Education for patients in hemodialysis: A systematic review. International Journal of Nursing Studies 2011;48(12):1570–1586. https://doi.org/10.1016/j.ijnurstu.2011.08.006

Qiao J, Shan Y, Chen Q, Xu ZP. Design and application of weight gain graphs based on Bandura’s self-efficacy theory for patients on maintenance haemodialysis. International Journal of Nursing Sciences. 2014;1(1):110–116. https://doi.org/10.1016/j.ijnss.2014.02.012

Ören B, Enç N. Development and psychometric testing of the self-cara agency scale for patients undergoing long-term dialysis in Turkey. Journal of Renal Care. 2014;40(4):266–273.

Nunes WJA. Education of Patients with Chronic Kidney Disease at the Interface of Primary Care Providers and Nephrologists. Advances in Chronic Kidney Disease. 2013;20(4):370–378. https://doi.org/10.1053/j.ackd.2013.03.002

Welch JL, Thomas-Hawkins C. Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: A review of intervention studies. International Journal of Nursing Studies. 2005;42(5):597–608. https://doi.org/10.1016/j.ijnurstu.2004.09.015

Trask MA, Rozon C, Puyah JH, Constantini L, Mackay M, Ocampo LL, Marchuk S. The Evaluation of an Orientation Program of Self-Care Abilities for Patients on Hemodialysis. Nephrology Nursing Journal. 2016;43(6): 501–511.

Bryson JD. Engaging adult learners: Philosophy, principles and practices. Barrie: James David Bryson; 2013.

Florea R. Teaching methods in adult education. An appraisal of the effectiveness of methods used in training future teachers. Procedia - Social and Behavioral Sciences. 2014;142:352–358.

UNESCO. Teaching methods in adult education. An appraisal of the effectiveness of methods used in training future teachers. In:ACCU, editor.UNESCO [Internet]. Shinjuku: UNESCO. 2001. Available from www.accu.or.jp/litdbase

Crown S, Vogel JA, Hurlock-chorostecki C. The effect of interdialytic fluid weight gain in patients on hemodialysis: a pilot study using motivational interviewing. Nephrology Nursing Journal. 2017;44(1):49–55.

Moore Q, Johnson A. Best practice for using health education to change behavior [Internet]. 2015.[cited 18/6/2017]. Available from http://bakerinstitute.org/research/best-practices-using- health-education-change-behavior/

Sousa VD. Conceptual analysis of business intelligence. Online Braz Journal of Nursing. 2002;1(1):3–12.

Chen GD, Huang CN, Yang YS, Lew-Ting CY. Patient perception of understanding health education and instructions has moderating effect on glycemic control. BMC Public Health. 2014;14(1).

Brown DC, Hummer RA, Hayward MD. The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States. Population Research and Policy Review. 2014;33(1):127–151.

Refbacks

  • There are currently no refbacks.