Can addressing family education improve adherence of therapeutic regimen in hemodialysis patients? A randomized controlled clinical trial

• Main Authors: Parvaneh Asgari, Mitra Zolfaghari, Azadeh Shaabani
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2015-10-01
• Series: Nursing Practice Today
• Subjects: family-centered education; patient-centered education; adherence to therapeutic regimen; hemodialysis
• Online Access: https://npt.tums.ac.ir/index.php/npt/article/view/34

Background & Aim: Today, one of the leading causes of pathogenicity and mortality in patients undergoing hemodialysis is their failure to follow the treatment plan. The present research was con- ducted to compare effects of patient-centered  education with family-centered  education on adher- ence with the treatment program. Methods & Materials: This clinical trial was performed between May and October 2012 in hemo- dialysis ward of Imam Khomeini and Amir-Alam hospital in Tehran, Iran. Research samples were60 patients aged 18-65 years old, randomly assigned into two groups: Training the patients (30 pa-tients) and training the patients and one of close family member (30 people). Using a researcher made questionnaire,  patients’ adherence (diet, pharmaceutical  regimen, and physical activity) was examined by the self-reporting method in three stages (before intervention, 2 and 4 weeks after in- tervention). Data were analyzed using independent t-test, Chi-square, and Fisher tests using SPSS software version 16. Results: Prior to intervention, there was no significant difference between the two groups in terms of adherence to diet program (P = 0.200, mean difference 25.8 ± 25.7), to pharmaceutical  regimen (P  =  0.600,  mean  difference  1.96  ±  0.61),  and  physical  activity  (P  =  0.700  mean  difference1.33 ± 0.66). After 2 weeks family-centered education group had significantly more adherence to the diet program (P = 0.001, mean difference 43.1 ± 11.1), pharmaceutical  regimen (P = 0.040, mean difference 2.72 ± 0.5) and physical activity (P = 0.035, mean difference 2.41 ± 0.89), and total ad- herence score (P = 0.030) in comparison with patient-centered education group. After 4 weeks, just the   adherence   to  pharmaceutical   regimen   showedn a significant difference between groups (P < 0.001). Conclusion: The results of this study showed that the family-centered  education is more effective than patient-centered education on patients’ adherence to the therapeutic program particularly phar- maceutical regimen, which suggests, by having family-centered education in hemodialysis patients, the outcome could be improved.