End-Stage Kidney Disease (ESKD), Maintenance Hemodialysis (MHD)
Conditions
Keywords
Maintenance Hemodialysis, Health Coaching, Self-Management, Self-Efficacy, Nursing Intervention
Brief summary
This study is a quasi-experimental study designed to evaluate the effects of a health coaching intervention on self-management ability in patients undergoing maintenance hemodialysis. Patients receiving maintenance hemodialysis will be recruited from the hemodialysis center of the study hospital. Participants in the intervention group will receive a structured health coaching intervention in addition to routine care, while participants in the control group will receive routine care. The intervention aims to improve patients' self-management ability by providing individualized health education, goal setting, self-management guidance, follow-up support, and feedback. The main outcome of this study is self-management ability. Secondary outcomes may include self-efficacy, disease knowledge, and treatment adherence.
Interventions
BEHAVIORALHealth Coaching
The health coaching intervention is a structured 6-month behavioral intervention delivered in addition to routine treatment and nursing care. It includes face-to-face communication during dialysis and follow-up support via a WeChat group. The intervention follows eight steps: contact, observation, education, reinforcement, clarification, assistance, encouragement, and guidance. Main components include individualized assessment, hemodialysis-related health education, teach-back-based knowledge reinforcement, individualized goal setting, action planning, health diary recording, family support, feedback on goal achievement, behavioral encouragement, emotional support, and long-term self-management guidance.
OTHERRoutine Care
Routine care includes regular maintenance hemodialysis, routine treatment and nursing care, basic health education, dietary and fluid management guidance, vascular access care guidance, medication guidance, and answers to patients' health-related questions as needed during the 6-month study period.
Sponsors
Anhui Medical University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Participants will be assigned to either the health coaching group or the routine care group according to the quasi-experimental study design. The health coaching group will receive a structured health coaching intervention in addition to routine care, while the routine care group will receive routine care only.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients aged ≥18 years who met the diagnostic criteria for ESRD according to the KDIGO 2012 Clinical Practice Guideline, namely a glomerular filtration rate of less than 15 mL/min/1.73 m². 2. Patients who have received regular maintenance hemodialysis for at least 3 months, with a dialysis frequency of three times per week. 3. Patients with a relatively stable clinical condition and no severe complications that may affect participation in the study. 4. Patients who are conscious, have normal communication ability, and are able to cooperate in completing the study procedures and questionnaires. 5. Patients who have no plan to change dialysis centers or travel for an extended period during the intervention period. 6. Patients who voluntarily agree to participate in this study and provide informed consent.
Exclusion criteria
1. Patients with severe cognitive impairment, mental disorder, or communication difficulties that prevent participation in the intervention or completion of questionnaires. 2. Patients with severe acute illness or unstable clinical condition. 3. Patients who are unable or unwilling to complete the 6-month intervention or follow-up. 4. Patients participating in another similar intervention study during the same period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-Management Ability | Baseline, 3 months after the intervention, and 6 months after the intervention | Self-management ability will be assessed using the Maintenance Hemodialysis Self-Management Scale at baseline, 3 months after the intervention, and 6 months after the intervention. The scale consists of 20 items and includes four dimensions: problem solving, self-care, partnership, and emotional management. Each item is scored on a 4-point Likert scale, ranging from 1 to 4. The total score ranges from 20 to 80, with higher scores indicating better self-management behavior. Changes in self-management ability across the three time points will be evaluated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Knowledge | Baseline, 3 months after the intervention, and 6 months after the intervention | Disease knowledge will be assessed using the Maintenance Hemodialysis Patient Knowledge Questionnaire at baseline, 3 months after the intervention, and 6 months after the intervention. The questionnaire consists of 24 items covering five topics: anemia, diet and medication, kidney function, dialysis treatment, and rehabilitation. Each item is scored as 1 for a correct answer and 0 for an incorrect or "do not know" answer. The total score ranges from 0 to 24, with higher scores indicating a higher level of disease knowledge. Changes in disease knowledge across the three time points will be evaluated. |
| Self-Efficacy | Baseline, 3 months after the intervention, and 6 months after the intervention | Self-efficacy will be assessed using the Chronic Disease Self-Efficacy Scale at baseline, 3 months after the intervention, and 6 months after the intervention. The scale consists of 6 items and includes two dimensions: symptom management and common disease management. Each item is scored from 1 to 10, ranging from "not at all confident" to "totally confident." The total score is calculated as the mean score of the 6 items, ranging from 1 to 10. Higher scores indicate higher levels of self-efficacy. Changes in self-efficacy across the three time points will be evaluated. |
| Treatment Adherence | Baseline, 3 months after the intervention, and 6 months after the intervention | Treatment adherence will be assessed using the Maintenance Hemodialysis Patient Treatment Adherence Scale at baseline, 3 months after the intervention, and 6 months after the intervention. The scale consists of 23 items and includes four dimensions: dietary adherence, fluid adherence, medication adherence, and dialysis adherence. Each item is scored on a 5-point scale, with higher scores indicating better treatment adherence. Changes in treatment adherence across the three time points will be evaluated. |
Countries
China
Outcome results
None listed