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Nurse-Led Dialysis Self-Management Program for Hemodialysis Distress
The Effect of a Nurse-Led Needs-Based Dialysis Self-Management Program on Dialysis-Related Distress in Hemodialysis Patients: A Randomized Controlled Trial
Hemodialysis patients may experience dialysis-related distress due to long-term treatment requirements, dietary and fluid restrictions, medication use, vascular access problems, dialysis-related symptoms, and psychosocial challenges. Nurse-led self-management programs may help patients improve dialysis self-management, reduce distress, and support treatment adherence.
This study aims to evaluate the effect of a nurse-led needs-based dialysis self-management program on dialysis-related distress in patients receiving hemodialysis. The study will be conducted as a single-center, two-arm, parallel-group, randomized controlled trial. A total of 100 adult hemodialysis patients will be randomly assigned to either the intervention group or the control group in a 1:1 ratio.
Participants in the intervention group will receive a 6-week nurse-led needs-based dialysis self-management program in addition to routine hemodialysis care. Participants in the control group will continue routine hemodialysis care. Data will be collected at baseline, 6 weeks, and 18 weeks. The primary outcome is dialysis-related distress. Secondary outcomes include illness and treatment uncertainty, treatment adherence, and clinical adherence indicators.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
The intervention is a structured, non-invasive, education- and counseling-based behavioral nursing intervention. The nurse-led needs-based dialysis self-management program aims to improve self-management skills, reduce dialysis-related distress, decrease illness and treatment uncertainty, and support treatment adherence.
The program will be delivered over 6 weeks through weekly face-to-face individual sessions lasting approximately 40 to 45 minutes. The intervention includes two components: standard core education and needs-based individualized counseling. Standard core education will be delivered to all participants in the intervention group. Individualized counseling will be guided by participants' baseline dialysis-related distress, illness and treatment uncertainty, treatment adherence, and clinical indicators.
The intervention content includes the hemodialysis process and individual needs assessment, fluid management and interdialytic weight control, diet and potassium/phosphorus management, medication adherence and treatment continuity, symptom and distress management, coping with treatment uncertainty, and development of a sustainable self-management plan. Intervention fidelity will be monitored using a standardized session checklist.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Serkan Budak, PhD / RN
- Telefoonnummer: +905385430616
- E-mail: serkan.budak@ksbu.edu.tr
Studie Locaties
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Simav, Turkije (Türkiye)
- Werving
- Simav Doc. Dr. Ismail Karakuyu State Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Aged 18 years or older
- Receiving hemodialysis treatment for at least 3 months
- Receiving hemodialysis treatment at least twice per week
- Able to read and understand Turkish
- Conscious and able to communicate
- Providing written informed consent
Exclusion Criteria:
- Advanced cognitive impairment
- Active psychiatric crisis
- History of major surgery or acute severe illness within the last 3 months
- Planned kidney transplantation in the near future
- Serious physical or communication problems that may prevent regular participation in the intervention sessions
- Concurrent participation in another structured education or psychosocial intervention program
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Nurse-Led Needs-Based Dialysis Self-Management Program
Participants in this arm will receive a 6-week nurse-led needs-based dialysis self-management program in addition to routine hemodialysis care.
The program includes weekly face-to-face individual sessions lasting approximately 40 to 45 minutes.
The intervention includes standard core education and needs-based individualized counseling focused on fluid management, diet, medication adherence, symptom and distress management, treatment uncertainty, and sustainable dialysis self-management.
|
The intervention is a structured 6-week nurse-led needs-based dialysis self-management program.
It will be delivered through weekly face-to-face individual sessions lasting approximately 40 to 45 minutes.
The program includes standard core education and needs-based individualized counseling.
The content focuses on the hemodialysis process and individual needs assessment, fluid management and interdialytic weight control, diet and potassium/phosphorus management, medication adherence and treatment continuity, symptom and distress management, coping with treatment uncertainty, and development of a sustainable dialysis self-management plan.
Intervention fidelity will be monitored using a standardized session checklist.
|
|
Actieve vergelijker: Routine Hemodialysis Care
Participants in this arm will continue to receive routine hemodialysis care.
No additional structured education or counseling program will be provided by the research team during the study period.
|
Participants will continue to receive routine hemodialysis care.
No additional structured education or counseling program will be provided by the research team during the study period.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Dialysis-Related Distress Assessed by the Hemodialysis Distress Thermometer
Tijdsspanne: Baseline, 6 weeks, and 18 weeks
|
Dialysis-related distress will be assessed using the Hemodialysis Distress Thermometer.
The instrument includes a distress barometer scored from 0 to 10, where 0 indicates no distress and 10 indicates extreme distress.
Higher scores indicate higher perceived dialysis-related distress.
The instrument also includes a 40-item problem checklist scored from 0 to 40, where higher scores indicate a greater number of distress-related problems.
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Baseline, 6 weeks, and 18 weeks
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Illness and Treatment Uncertainty Assessed by the Uncertainty in Chronic Dialysis Treatment Scale
Tijdsspanne: Baseline, 6 weeks, and 18 weeks
|
Illness and treatment uncertainty will be assessed using the Uncertainty in Chronic Dialysis Treatment Scale.
The scale includes 17 items and five subscales.
Total raw scores range from 17 to 85 and can be transformed to a 0 to 100 scale.
Higher scores indicate higher illness and treatment uncertainty.
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Baseline, 6 weeks, and 18 weeks
|
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Treatment Adherence Assessed by the End-Stage Renal Disease Adherence Questionnaire
Tijdsspanne: Baseline, 6 weeks, and 18 weeks
|
Treatment adherence will be assessed using the End-Stage Renal Disease Adherence Questionnaire.
The scale includes 9 items and four subscales: hemodialysis attendance, medication use, fluid restriction, and diet restriction.
Total scores range from 0 to 1200.
Higher scores indicate higher adherence to treatment.
|
Baseline, 6 weeks, and 18 weeks
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Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- Liu L, Liu YP, Wang J, An LW, Jiao JM. Use of a knowledge-attitude-behaviour education programme for Chinese adults undergoing maintenance haemodialysis: Randomized controlled trial. J Int Med Res. 2016 Jun;44(3):557-68. doi: 10.1177/0300060515604980. Epub 2016 Mar 7.
- Liu Y, Luo X, Ru X, Wen C, Ding N, Zhang J. Impact of a multimodal health education combined with teach-back method on self-management in hemodialysis patients: A randomized controlled trial. Medicine (Baltimore). 2024 Dec 27;103(52):e39971. doi: 10.1097/MD.0000000000039971.
- Sousa H, Ribeiro O, Figueiredo D. Development process, clinical utility, and preliminary psychometric evidence of a new tool for screening psychological distress in renal care settings: the Hemodialysis Distress Thermometer (HD-DT). Psychol Health. 2025 Oct;40(10):1658-1684. doi: 10.1080/08870446.2024.2347662. Epub 2024 Apr 28.
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Studie voltooiing (Geschat)
Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- KSBU-HD-RCT-2026-01
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