The Effect of Education Given to Hemodialysis Patients on Patients' Self-Care Ability and Fluid Control

Chronic diseases are one of the major public health problems. Chronic renal failure (CKD) is among the chronic diseases that cause death worldwide. CKD is defined as a chronic and progressive deterioration in the kidney's fluid-solute balance adjustment and metabolic-endocrine functions resulting from a decrease in glomerular filtration rate. CKD affects approximately 10-15% of adults worldwide and 15.7% of adults in Turkey. Renal replacement treatment options for CKD are peritoneal dialysis, hemodialysis (HD) and kidney transplantation. The most common treatment method applied is HD. It was reported that 76% of patients with CKD in Turkey at the end of 2017 received HD treatment. The aim of HD is to correct the patient's fluid and electrolyte imbalance, prevent possible complications, compensate for the patient's lost renal functions as much as possible and increase the quality of life. However, in addition to these, diet causes negativities such as fluid restriction, depression, job loss, loss of role in family life, fear of death, and decreased self-care ability in HD patients. Self-care ability is defined as "a dynamic process that enables individuals to participate in health services". Lack of self-care ability makes it difficult to adapt to the disease. Therefore, it negatively affects the treatment and increases the cost of the disease. Self-care behaviors in HD patients include appropriate diet intake, regular medication use, compliance with fluid restriction, and coping with stress. Studies show that there is a correlation between the level of self-care in HD patients and compliance with treatment, health-enhancing behaviors, and the reduction of physical and psychological symptoms. For this reason, it is important to develop self-care ability in order to protect and improve the quality of life of HD patients and to prevent possible complications. The area that creates the most stress in HD and makes it difficult to comply with treatment is fluid restriction. Non-compliance with fluid restriction is reported as 30.6-95% in Turkey and 15.3-80% worldwide. As the disease progresses, HD patients lose their ability to form urine. Therefore, the amount of fluid consumed becomes important. In addition, excessive fluid loading in patients increases mortality rates. For this reason, fluid restriction control should be made a lifestyle in disease management. Nurses who respond to and intervene in patients' needs instantly have great duties and responsibilities. It can be said that nursing care and education are of great importance in solving existing or potential problems of individuals receiving HD treatment. Patient education, which is within the scope of the nurse's educational role, ensures that the patient is protected from possible complications, can control fluids, increases self-care ability, and gains behavioral changes related to their health. The effects of education given to HD patients on various parameters have been examined in the literature. However, no study examining the self-care ability and fluid restriction of education has been found. Therefore, this study was conducted to examine the effects of education given to patients receiving HD treatment on self-care ability and fluid control.