Effects of self-regulation program on volume overload control in end-stage renal disease patients undergoing peritoneal dialysis at Nakornping Hospital
Keywords:
end-stage renal disease, peritoneal dialysis, volume overload, self-regulationAbstract
Background: Volume overload is a significant complication in end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD), often leading to unplanned hospital readmissions. Self-regulation programs can effectively promote behavioral changes and help control volume overload.
Objective: To compare mean scores of knowledges, self-efficacy, outcome expectations, and sodium and fluid consumption behaviors between experimental and control groups before and after program participation, and to compare the incidence of volume overload between the two groups post-intervention.
Methods: A quasi-experimental study was conducted on 80 ESRD patients undergoing PD at the Peritoneal Dialysis Clinic, Nakornping Hospital, from November 2023 to February 2024. Participants were selected based on inclusion and exclusion criteria. Research instruments included: 1) A 9-week self-regulation program for volume overload control in ESRD patients on PD, 2) A patient handbook "Kidney Care Without Edema”3) Self-monitoring records for sodium and fluid intake, and 4) Educational slide presentations on volume overload control. Data was analyzed using descriptive statistics, frequency, percentage, and chi-square tests.
Results: The study included experimental and control groups (40 patients each). In the experimental group, 55.0% were male, compared to 42.5% in the control group. Most participants were over 60 years old (62.5% and 70.0%), had sufficient but no savings income (50.0% and 67.5%), were primarily cared for by their children (32.5% and 45.0%), and had primary education (60.0% and 35.0%). High peritoneal transport status was found in 47.5% and 62.5% of participants respectively. Post-intervention, the experimental group showed significant improvements in mean knowledge scores (from 7.07±1.98 to 8.67±2.89, p<0.001), self-efficacy (from 57.57±15.59 to 66.10±12.68, p=0.016), and sodium and fluid consumption behaviors (from 41.47±5.11 to 42.72±4.23, p=0.039 and from 6.40±1.26 to 6.85±0.58, p=0.006). The experimental group demonstrated significantly higher knowledge scores than the control group (8.67±2.89 vs 7.85±2.85, p=0.020). The experimental group showed 75% lower risk of volume overload compared to the control group, though not statistically significant (IRR = 0.25, 95% CI 0.005-2.526, p=0.219).
Conclusion: This self-regulation program shows potential in controlling volume overload in ESRD patients undergoing peritoneal dialysis.
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