| خلاصه مقاله | Background: Patients with end-stage kidney disease (ESKD) suffer from uncertainty in illness and low activation. Individualized education is a new approach in which education is provided based on the patient’s needs and preferences. This study aims to assess the influence of nurse-guided individualized education on uncertainty in illness and activation among patients undergoing hemodialysis (HD).
Methods: In this randomized clinical trial, 102 HD patients in Tabriz (Iran), were randomly assigned to the intervention or control groups in 2023. Inclusion criteria were: Patients with ESKD aged over 18 years, patients who were undergoing HD at least three times a week for at least three months, absence of mental (severe depression and dementia) or cognitive disorders based on the Mini-Mental State Examination (MMSE). Exclusion criteria were: participant's unwillingness to continue the study, changing KRTs from HD to other treatments or changing the HD center during the study period, and patient participation in similar studies during the study. Patients in the intervention group (n=51) received individualized education based on their learning needs. The control group (n=51) received the printed educational brochures. The patients’ uncertainty in illness and the patient activation were assessed before the intervention, after the intervention, and three months after the last session of individualized education. Data were analyzed using SPSS software (v.26). A P-value less than 0.05 was considered significant.
Results: The results showed that the mean scores of uncertainty in illness and activation were not significantly different between the two groups before the intervention (P = 0.56, P = 0.46). However, the mean total score of uncertainty in illness in the intervention group were lower than the control group immediately and three months after the intervention (P<0.001). Also, a significant increase in patient activation was found in the intervention group compared with the control group (P<0.001).
Conclusion: In conclusion, it is recommended to make changes in patient education strategies and utilize effective educational methods by considering each patient’s needs and preferences. Moreover, it is recommended to use individualized education at the early stage of CKD. |