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

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