Effect of Hemodialysis Therapy Education on Fluid Management of Patients with Chronic Kidney Disease: A Single-group Pretest-Posttest Study.

Abstract

Background: Effective fluid management is necessary to avoid fluid overload problems in patients with chronic kidney disease (CKD) receiving hemodialysis therapy. The goal of hemodialysis patients' customized health education programs is to raise their comprehension of fluid management thereby improving their well-being. Objective: To assess the effect of health education intervention on fluid management of CKD patients undergoing hemodialysis in Dialysis Units, National Hospital of Sri Lanka (NHSL), Colombo, Sri Lanka Methods: A single-group pretest-posttest design was employed among 110 CKD patients undergoing hemodialysis therapy. Simple random sampling technique was utilized to select the sample. Data on demographic characteristics, medical history, signs and symptoms indicating fluid overload, and fluid management status were collected using a content validated, interviewer administered questionnaire. Individual health education sessions were conducted followed by information leaflets shared to remember important home instructions and emphasized the importance of fluid adherence during subsequent visits. The questionnaire was re-administered after the completion of a one-month follow-up period. Descriptive statistics and paired t-tests were used in the data analysis. Results: The majority were males (76.4%) and nearly 50% of patients were in the age group 51-70 years. The results demonstrated that health education had a beneficial effect on fluid management, as evidenced by an increase in overall pre and post-mean scores (50.8±13.51 vs 59.07±13.34, p<0.001) where high scores denote lower signs and symptoms and vice versa. There were significant differences between pre and post-test scores obtained for signs and symptoms of fluid overload including shortness of breath, ascites, oxygen saturation, and edema (pulmonary, peripheral, periorbital, facial, leg) (p<0.05), indicating the positive impact of health education intervention. Post weight gain of the patients was significantly lower than the pre-weight gain of patients p<0.001). Conclusions: Education intervention has a beneficial effect on fluid management in CKD patients receiving hemodialysis. This study highlights the importance of implementing regular health education interventions to improve the fluid management compliance of these patients.