Interventions to support Patient Activation for adults on hemoDialysis (IPAD Study)

Provide essential routine information on haemodialysis mechanism, symptom control, medication management, nutrition advice, fluid restriction, and coping methods; standard pamphlets and electronic resources Materials: Pamphlets from Kidney Health Australia and from resources provided by Monash Health, namely: Fluid Facts (Amgen) Low Phosphate (Amgen) Low Potassium - Fruit (Amgen) Low Potassium - Vegetable (Amgen) Calcium and phosphate balance with kidney disease fact sheet [Kidney Health Australia (KHA)] Drink water instead (KHA) Salt and your kidneys fact sheet (KHA) Hyperphosphataemia (Shire) One-on-one individual self-management training session conducted by trained nephrology nurses. The duration of the session depends on the participant's activation level; one hour for participants with low activation level and 30 minutes for highly activated participants. Content includes; 1) introduction to the self-management concept 2) addressing the importance and benefits of self-management 3) forming an action plan based on the self-management theory, introducing a log book to record blood pressure, fluid intake, daily weight, medications and diet. Follow-up phone calls with receptive interview techniques which encourage patient-initiated talk to address current concerns, goal settings, behavioural modifications, services utilizations Interventions delivered by the researchers - dialysis nurses involved in the study Delivery: face-to-face (initial session) followed by telephone interviews as remaining contacts Number of times: as per protocol, minimum weekly for 4 weeks, gradually decreasing to fortnightly for 2 fortnights, then 1 month after that for 6 months for participants with lower activation levels. Interventions stop on the month following the fortnightly follow up for participants with high activation levels. Duration: 25 weeks for low activation participants; 9 weeks for high activation participants Interventions will be personalised to each individual in the intervention arm. This will occur by practicing motivational interview techniques to probe areas of concern from the participants, and in turn the interventions to be addressed on that particular follow up will be based on the participants' perceived problem list. Intervention adherence not assessed. Effectiveness will be assessed by post-intervention PAM score at the end of the treatment period, which will be 18 months after enrolment to the study. Location: Monash Medical Centre - Clayton VIC Australia 3168