Structured Nursing Education for Hemodialysis Patients

This randomized controlled trial was designed to evaluate the effects of a structured nurse-led education program on attitudes toward diet therapy, self-care activities, and chronic disease self-management among patients undergoing maintenance hemodialysis. The study was carried out in the hemodialysis unit of a private dialysis center in the Black Sea region of Türkiye. Sixty eligible patients receiving maintenance hemodialysis were randomly assigned to either an intervention group (n = 30) or a control group (n = 30). Cluster randomization at the dialysis-session level was used to minimize contamination between participants. Outcome data were analyzed by a blinded statistician. Participants in the intervention group received a structured nurse-led education program consisting of eight face-to-face sessions delivered over four weeks (two sessions per week). The educational program included chronic kidney disease and hemodialysis, treatment adherence, dietary therapy, nutritional management, fluid and electrolyte restrictions, self-care skills, chronic disease self-management, anemia management, and reinforcement of learning. The control group received routine care without additional educational intervention. The primary outcomes were attitudes toward diet therapy, self-care activities, and chronic disease self-management. These outcomes were assessed at baseline and immediately after completion of the intervention using validated instruments, including the Hemodialysis Patients' Attitudes Toward Diet Therapy Scale (HPADTS), the Self-Care Activities Screening Scale-14 (SCAS-14), and the Chronic Disease Self-Management Scale (CDSMS). The educational program was developed based on Orem's Self-Care Deficit Nursing Theory and was designed to address self-care, dietary therapy, and chronic disease self-management among patients undergoing maintenance hemodialysis.