Fluid compliance among patients having haemodialysis: can an educational program make a difference?
Barnett, AP and Tang, LY and Pinikahana, J and Tan, S-Y, Fluid compliance among patients having haemodialysis: can an educational program make a difference?, Journal of Advanced Nursing, 61, (3) pp. 300-306. ISSN 0309-2402 (2008) [Refereed Article]
Title. Fluid compliance among patients having haemodialysis: can an educational
programme make a difference?
Aim. This paper is a report of a study to examine the effectiveness of a patient
education programme on fluid compliance as assessed by interdialytic weight gain,
mean predialysis blood pressure and rate of fluid adherence.
Background. Patients with end stage renal disease who receive haemodialysis are
often non-compliant with their treatment regime, especially adherence to fluid
Method. An exploratory study was conducted in 2004–05 using a quasi-experimental,
single group design to examine the effectiveness of patient education on
fluid compliance in a dialysis centre located in a major teaching hospital in Kuala
Lumpur, Malaysia. Twenty-six patients with an interdialytic weight gain of greater
than 2Ć5 kg were identified as non-compliant and recruited to the study. The
intervention was carried out over a 2-month period and included teaching and
weekly reinforcement about diet, fluids and control of weight gain.
Findings. Patients’ mean interdialytic weight gain decreased following the educational
intervention from 2Ć64 kg to 2Ć21 kg (P < 0Ć05) and adherence to fluid
restrictions increased from 47% to 71% following the intervention. Predialysis
mean blood pressure did not improve following the intervention, although the
maximum recording for predialysis systolic pressure dropped from 220 mmHg to
161 mmHg. Whilst no statistically significant associations were detected between
interdialytic weight gain and age, educational level, marital status or employment
status, women demonstrated a greater decrease in mean interdialytic weight gain
Conclusion. Nephrology nurses often have long-term relationships with their patients
and are ideally placed to provide ongoing education and encouragement,
especially for those experiencing difficulties in adhering to fluid and dietary