Impact of Health Education Intervention on Fluid Management and Quality of Life Among Patients with Chronic Kidney Disease Undergoing Hemodialysis

Introduction: Chronic Kidney Disease (CKD) is a global concern, impacting over 13% of individuals. Hemodialysis (HD) poses challenges, and education on fluid management can improve quality of life (QOL) of individuals with CKD. This study is aimed to evaluate, the impact of health education intervention on fluid management and QOL among dialysis-receiving CKD patients in Dialysis units (DU) at the National Hospital of Sri Lanka (NHSL).
Methods: One-group pretest-posttest design was utilized. Two interviewer-administered questionnaires were used to collect data from randomly selected 110 CKD patients receiving HD. The instrument consisted of items assessing the history of the disease condition, signs and symptoms of fluid overload, and fluid management status. The Kidney Disease Quality of Life (KDQOL) questionnaire was used as instrument II. Both instruments were administered before and after health education intervention regarding control of fluid intake during HD. Descriptive statistics and paired samples t-tests were performed for data analysis. The Ethics Review Committee of NHSL approved this study.
Results: The study primarily involved CKD patients, with a significant majority (46.4%) falling in the 51-70 years age group, and a predominance of males (76.4%). Almost half (44.5%) had attained education up to the Ordinary Level, and the majority were married (80.9%). The findings revealed a positive impact of health education sessions on fluid management, with post-scores increasing from 67% to 79%, indicating a significant reduction in fluid overload symptoms (p<0.05). However, pre- and post-quality-of-life scores did not show significant differences (p=0.051) with the effect of education intervention.
Conclusions: The results revealed a significant reduction in fluid overload symptoms after the educational intervention, indicating a positive impact on fluid management. However, the same intervention did not demonstrate an observable improvement in the patient's quality of life, emphasizing the need to explore the underlying reasons for remaining QOL unchanged. Since health education intervention has shown a positive impact on fluid status management of CKD patients undergoing HD, it would be beneficial to conduct such intervention across DU in Sri Lanka after further studies.