Impact of an Educational Program on fluid compliance in patients on chronic haemodialysis in four dialysis centers in Khartoum State

Samah A Abukana, Saud A Salheein, Fatthia O Makki, Safa M M Nour


Introduction Failure to adhere to fluid restriction can lead to complications such as congestive heart failure, pulmonary edema, lower limb edema, hypertension and fatal consequences. Researchers reported that up to 50% of patients having haemodialysis are non-compliant with their fluid restriction.The aim ofthe study was to assess the impact of educational program on fluid compliance among non-compliant chronic haemodialysis (CHD) patients evidenced by interdialytic weight gain (IDWG), mean pre-dialysis blood pressure (BP) and rate of fluid adherence (RFA).Materials and methods This study is an interventional study with pre and post design. It was carried out at four governmental dialysis centers in Khartoum State; 84 patients out of 92 completed the study. The core of the study was non-compliant CHD patients. Non-compliance is defined as three or more episodes of interdialytic weight gain of 2.5 kg or more over a month period. The data were collected using structured questionnaire and fluid compliance monitoring chart.Results Friedman test showed that mean IDWG was found to decrease significantly from 2.63kg pre-intervention to 2.20 kg in post-intervention to 2.15 kg in follow up (p <0.05). There was also significant difference between pre-intervention mean blood pressure (BP) of 102.94 mmHg and post-intervention mean BP of 99.17mmHg as well as between pre-intervention mean BP and follow up mean BP of 95.05 mmHg (p <0.00). The mean rate of fluid adherence markedly increased from 36.68% in pre-intervention to 76.89% in post-intervention to 78.54 % in the follow up phase; these changes of RFA were also significant (p <0.00). There was also a significant difference between pre-intervention and post-intervention serum sodium and a significant difference between post-intervention serum sodium and follow up serum sodium (p<0.00). Conclusions The results showed significant changes in the mean IDWG, mean BP, mean RFA and serum sodium following the intervention program. This emphasizes the need for education of CHD patients to improve knowledge and attitude toward fluid control.


Impact of an Educational Program;fluid compliance in patients;chronic haemodialysis;dialysis centers

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World Health Organization (WHO). Adherence to long-term therapies: Evidence for action: 2013. 2. Casey J, Johnson V, McClelland P. The relationship between interdialytic weight gain and patient compliance. A single centered cohort study (n=21). Edtna Erca J 2001;27(4):187-9. 3. Cvengros J, Christen A, Lowrton W. The role of perceived control and preference for control in adherence to chronic medical regimen. Ann Behav Med 2004;27(3):155-161.4. Wolcott DW, Maida CA, Diamond R, Nissenon AR. Treatment compliance in end stage renal disease patients on haemodialysis. Am J Nephrol 1986;6(1):329-338.5. Baraz S, Parvardeh S, Mohammadi E, Broumand B. Dietary and fluid compliance: an educational intervention for patients having haemodialysis. J Advanced Nursing 2010;66(1):60-68. 6. Barnett T, Li Yoong T, Pinikahana J, Si-Yen T. Fluid compliance among patients having haemodialysis: can an educational programme make a difference? .J Advanced Nursing 2008;61(3):300-306. 7. Wells J. Hemodialysis knowledge and medical adherence in African Americans diagnosed Samah A Abukana, Saud A Salheein, Fatthia O Makki, Safa M M Nour

with end stage renal disease: Result of an educational intervention. Nephrol Nursing J 2011;38(2):155-163.8. Elaine F, Kathleen Y, Molaison M. Stages of change and fluid intake in dialysis patients. Patient Education and Counseling J 2003;49:5-12. 9. Rambod M, Peyrav H, Shokpour Nagh M. Dietary and fluid adherence in Iranian haemodalysis paients. The Health Care Manager 2010;29(4):359-64. 10. Mahan K, Escott–Stump S, Raymond JL. Krauss’ Food and Nutrition Care Process, 13th Edition. Elsevier; 2003.11. Thomas G, John E, Lawrence J, et al. Recommendations for blood pressure measurement in human and experimental animal. Am Heart Assoc J 2005;45:142-161.12. Oshuondi K, Fathababi M, Mahjub H, et al. Effect of small group education on interdialytic weight gain, and blood pressure in haemodialysis patients. Nursing and Midwifery Studies 2013;1(3):128-132


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