Abstract:
Background: Effective fluid management is necessary to avoid fluid overload problems in
patients with chronic kidney disease (CKD) receiving hemodialysis therapy. The goal of
hemodialysis patients' customized health education programs is to raise their comprehension of
fluid management thereby improving their well-being.
Objective: To assess the effect of health education intervention on fluid management of CKD
patients undergoing hemodialysis in Dialysis Units, National Hospital of Sri Lanka
(NHSL), Colombo, Sri Lanka
Methods: A single-group pretest-posttest design was employed among 110 CKD patients
undergoing hemodialysis therapy. Simple random sampling technique was utilized to select the
sample. Data on demographic characteristics, medical history, signs and symptoms indicating
fluid overload, and fluid management status were collected using a content validated, interviewer
administered questionnaire. Individual health education sessions were conducted followed by
information leaflets shared to remember important home instructions and emphasized the
importance of fluid adherence during subsequent visits. The questionnaire was re-administered
after the completion of a one-month follow-up period. Descriptive statistics and paired t-tests were
used in the data analysis.
Results: The majority were males (76.4%) and nearly 50% of patients were in the age group 51-70
years. The results demonstrated that health education had a beneficial effect on fluid management,
as evidenced by an increase in overall pre and post-mean scores (50.8±13.51 vs 59.07±13.34,
p<0.001) where high scores denote lower signs and symptoms and vice versa. There were
significant differences between pre and post-test scores obtained for signs and symptoms of fluid
overload including shortness of breath, ascites, oxygen saturation, and edema (pulmonary,
peripheral, periorbital, facial, leg) (p<0.05), indicating the positive impact of health education
intervention. Post weight gain of the patients was significantly lower than the pre-weight gain of
patients p<0.001).
Conclusions: Education intervention has a beneficial effect on fluid management in CKD patients
receiving hemodialysis. This study highlights the importance of implementing regular health
education interventions to improve the fluid management compliance of these patients.
