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Fluid compliance amongst haemodialysis patients at the University Malaya Medical Center (UMMC)
thesisposted on 09.01.2017, 02:36 by Tang, Li Yoong
Background: Patients with end stage renal disease who receive haemodialysis are often found to be non compliant with their treatment regime and dialysis therapy, mainly fluid intake. Poor fluid compliance contributes to hypertension and cardiovascular complications which contribute to increased mortality among the haemodialysis population. Patient education is an advocated strategy to improve compliance. Purpose: This was a quasi- experimental, one group study design. It was conducted to determine fluid compliance among haemodialysis patients and examine the effectiveness of patient teaching on fluid compliance. Methods: This study took place in a hospital based dialysis center. From the population of forty three patients who registered with the chronic haemodialysis program, twenty six patients were recruited based on inclusion criteria: age 18 years and above, more than six months dialysis, undergoing three times dialysis session weekly, not hospitalized and had an average interdialytic weight gain of more than 2.5 kg. Teaching sessions on purpose of haemodialysis, complications of volume overload, fluid and salt intake, and weight gain control were carried out for one month. At the beginning of the educational program, patients received 20-30 minutes individual teaching. Subsequently, positive reinforcement and encouragement was given weekly. Two months post teaching data on weight and blood pressure was assessed. The outcome measures were mean interdialytic weight gain and mean predialysis blood pressure. Data on interdialytic weight gain, pre and post dialysis blood pressure were collected at baseline and two months following the intervention. Data was analyzed by descriptive statistics, paired t-test and correlations. Results: Patients mean interdialytic weight gain decreased following the teaching intervention, but the mean blood pressure did not improve after intervention. The results were statistically significant in weight gain (p<0.05). There were no association between age, educational level, marital status, employment status, duration of dialysis and concurrent disease. Conclusion: The study supports the effectiveness of patient teaching in controlling their interdialytic weight gain and promoting compliance with fluid restrictions. However, further studies should include larger sample size and measure other factors that might influence compliance.