Effects Of Empowerment-based Education On Fluid-intake Of Hemodialysis Patients

ObjectivesTo explore the effects of empowerment-based education on fluid-intake ofhemodialysis（HD） patients, and evaluate the results from patient’s inter-dialyticweight gain（IDWG）, disease management self-efficacy and self-management.MethodsA quasi-experimental design was used.Totally94HD patients were randomlydivided into two groups.47patients in the intervention group receivedempowerment-based education for12weeks,47patients in the control groupreceived routine care.Empowerment-based education consist of group discussion andindividual education, five step empowerment approach was used, namely evaluatepatient’s current water control situation, identify problems, express feelings, set goals,make a plan for a behavioral step and assess how the experiment worked.The scoresof IDWG, self-efficacy and self-management were compared pre-post test.Theinstruments include demographic questionnaire, IDWG, Self-Efficacy Scale forChronic and Self-Management Scale for Hemodialysis.The questionaires werehanded out by the researcher after obtaining patients’ informed consent. The datawere collected and then input the statistic software after logical check strictly. The SPSS17.0was used to analyse the data. The statistic methods included descriptivestatistical analysis, t-test and Chi-square analysis.Results94patients undergoing hemodialysis were selected conveniently,7（7.45%）patients were lost for the reason of transfer to other hospital, kidney transplantation,illness progression or death,so87patients were left,47patients in the interventiongroup and40patients in the control group.1.Independent t test show that there were statistically diference in patients’IDWG in the pre-post intervention between two group（P0.0220.05）.Anddescriptive statistics of mean IDWG of intervention group was （2.49±0.92）kg,which was to （2.02±0.75）kg（decreased by0.47kg） after12weeks. Pairedt test show that there was statistically significant diference （P0.0000.01） in it.2.Independent t test show that there were statistically significant diference（P0.0000.01） in patients’ self-efficacy in the pre-post test,and the items of“Confidence of control the depressive mood”,“Confidence of take some self-carebehavior”“,Confidence of do something to reduce disease impact on daily life” werehave statistically significant diference （P0.0000.01）.Paired t test show thatthere was statistically significant diference （P0.000~0.0030.01） in patients’self-efficacy of intervention group in the pre-post test.3.Independent t test show that there were statistically significant diference（P0.0000.01）in patients’self-management ability in the pre-post test betweentwo group, and the dimension of “partnership” was statistically diference（P0.0160.05）, and there were statistically significant diference（P0.000~0.0010.01）in other three dimensions. Paired t test show that therewas statistically significant diference （P0.0000.01） in patients’self-management ability of intervention group in the pre-post test.The fourdimensions increase degree from big to small was emotional manage capacity（increased by1.10）, compared with before, perform self-care ability （increased by0.42）, ability to establish partnerships with medical staff and patients （increased by 0.40） and problem solving ability （increased by0.35）.ConclusionEmpowerment education program can improve patient’s self-efficacy andself-management of their own disease, control their fluid intake volume.