Effect of an Educational Program on Adherence to Therapeutic Regimen among Chronic Kidney Disease Stage5 (CKD5) Patients under Maintenance Hemodialysis

Abstract

The burden of chronic disease on health care services worldwide is growing and the increased development of educational interventions which help patients to better manage their conditions is evident internationally. It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients. Adherence to fluid restrictions, dietary and medication guidelines as well as attendance at prescribed hemodialysis sessions of a hemodialysis regimen are essential for adequate management of chronic kidney disease. The objective of the present study is to  investigate the effect of an educational program on adherence to therapeutic regimen among chronic kidney disease stage 5 (CKD5) patients under maintenance hemodialysis at Kasr AlAiny center for Nephrology, Dialysis and transplantation (KAC-NDT), Cairo University. To fulfill the aim of this study a purposive sample of sixty adult male and female patients on maintenance hemodialysis for at least 6 months and not more than one year were assigned. Socio-demographic and medical data sheet, laboratory investigation assessment data sheet, pre/post knowledge assessment data sheet and adherence assessment data sheet were utilized for data collection. The study results revealed, the post total mean knowledge scores of the study subjects increased significantly in follow up assessment times  as compared to the pre-program assessment (X²=  186.332, P= 0.001). The post total mean adherence scores of the study subjects is increased significantly in follow up assessment times  as compared to the pre-program assessment ( X²= 34.587 , P= 0.001).  Frequent and repeated contacts with renal nurses can help these patients develop problem-solving skills, set goals, and understand their progress in managing multiple aspects of their disease. Individualization of the common educational approach by incorporating the patient’s beliefs, behaviors, and emotional and physical feelings as well as culture, economic situation, ability and knowledge of the disease and its treatment supports self- management.

Key wards: chronic kidney disease, hemodialysis, knowledge, adherence, diet and fluid restrictions.