The Effectiveness of a Care Model for End-stage Renal Disease Patients with Hyperkalemia and Hyperphosphatemia in the Nephrology clinic, Lang Suan Hospital, Chumphon Province

Abstract

     This two-group pretest–posttest quasi-experimental study aimed to examine the effectiveness and satisfaction with a care model for patients with end-stage kidney disease with hyperkalemia and hyperphosphatemia. The sample comprised 80 patients with end-stage kidney disease who had serum potassium levels >5.5 mmol/L and serum phosphorus levels > 4.5 mg/dL. Participants were assigned to an experimental group and a comparison group, with 40 participants in each group. The experimental group received the care model, which comprised: 1) assessment of patients’ self-care behaviors; 2) education on potassium and phosphorus control; 3) provision of healthcare services; and 4) periodic follow-up and encouragement. The comparison group received usual care, consisting of healthcare services and advice on appropriate self-care practices. The intervention was implemented for 3 months. Research instruments included the care model, questionnaires, and health-record forms. Data were analyzed using descriptive statistics, the chi-square test, independent-samples t-test, and paired-samples t-test.

     The findings showed that, after receiving the care model, the experimental group had mean reductions in serum potassium and phosphorus of 1.1 mmol/L and 1.0 mmol/L, respectively. These values were lower than those observed in the usual-care group by 1.0 mmol/L and 0.9 mg/dL, respectively. Mean scores for knowledge of potassium and phosphorus control, behaviors related to potassium and phosphorus control, and medication-taking behavior improved by 1.1, 1.2, 4.9, 4.0, and 1.0 points, respectively, and were higher than those in the usual-care group by 0.9, 1.0, 4.5, 5.4, and 1.3 points, respectively (p < 0.05). In addition, 82.5% of patients reported a high level of satisfaction with the care model.

     The findings support the potential of this care model and suggest that it may be considered for adaptation in similar settings, with further monitoring and evaluation.