effect of a teaching program on nutritional practices for hemodialysis patients

ABSTRACT

Diet is an important factor for patients on hemodialysis [HD] to maintain good nutritional status and to enable the patient to eat palatable and enjoyable diet. Restricting protein, sodium, potassium, and fluid intake help to minimize uremic symptoms, fluid / electrolyte imbalances, accumulation of nitrogenous wastes, and may even postpone the initiation of dialysis for a few months. For patients with chronic renal failure, or ESRD, hemodialysis prevents death. However, it does not cure or reverse. These patients need to use a proper nutritional practice, which is a crucial intervention. The purpose of this study was to evaluate the effect of a teaching program on nutritional practices for patients undergoing hemodialysis. Thirty-five subjects: male [n=16] and female [n=19] patients were selected over a year. The study was conducted at dialysis units both in El-Manial University Hospital and King Fahd Units. A quasi-experimental research design was utilized in this study. One group, pre-post test design was implemented. Three tools were used to collect data; [1] demographic and medical data sheets, [2] assessment sheet, and [3] pre-post test sheet. Results indicated that there was a significant differences between nutritional knowledge scores before and after [34.73+3.46] [3mths, 75.36+3.51; 6mths, 88.31+6.24; F=86.18 at p=0.000] respectively conducting the program. Also, there was an improvement in practicing nutritional dietary habit, which was indicated by increased number of meals from 2-3 meals per day [X[2]=27.5 at p=0.001] and the amount of daily fluid intake decreased to one liter or less [X[2]=19.1 at p=0.001]. Physical examination assessment revealed that hair, nails, tongue and gums status were improved after changing nutritional habits and practice [X[2]=12.9, X2=16.7, X[2]=21.3, X[2]=40.1 at P<0.001, respectively]. A moderate improvement appeared in renal function tests [urea; F=3.388 at P=0.038, Creatinine; F=3.964 at P=0.022]. While serum electrolyte levels were about normal range before and after conducting the program. The study concluded that there was positive impact of the teaching program on the improvement of patient nutritional practices. The findings of this study showed that the education session can have an effect on patients' knowledge and compliance. The study findings implied the necessity of physician, nurse and dietician to devote some of their time to provide HD patients and their family with simple explanation about permitted and omitted food and fluid, and planning for a convenient amount and quality. In addition, distributing a dietary guide would prepare the patient for developing new skills in eating habits to gain satisfaction and increase the pleasures of life