Literacy Enhancement Program among Older People Receiving Hemodialysis: Feasibility and Acceptability

Authors

  • Krit Boonasa RN, MNS, Kuchinarai Crown Prince Hospital, Kalasin, Thailand.
  • Ladawan Panpanit RN, PhD, Gerontological Nursing Research Cluster, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
  • Samoraphop Banharak RN, PhD, Gerontological Nursing Research Cluster, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
  • Nutda Kumniyom RN, PhD, Gerontological Nursing Research Cluster, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
  • Sutin Chanaboon PhD, Sirindhorn College of Public Health, Khon Kean, Thailand.

Keywords:

Chronic kidney disease, Feasibility, Health literacy, Hemodialysis, Older people, Self-care behavior

Abstract

              The prevalence of chronic kidney disease is higher in older people. Hemodialysis helps reduce complications and extends life for people with chronic kidney disease, however several adverse effects occur frequently, varying from discomfort to life-threatening events. Though these effects can be reduced with appropriate self-care, older people receiving hemodialysis have limited self-care behaviors and health literacy. This study used a one-group pretest–posttest design aimed to examine the feasibility and acceptability of a health literacy enhancement program and the effects of the program on health literacy and self-care behaviors in older people with chronic kidney disease receiving hemodialysis. Eighteen participants receiving hemodialysis at a district hospital in Thailand were recruited. The program was developed based on the Model of Health Literacy. Data were collected from April to July 2020. The feasibility and acceptability of the program were determined by retention of study participants and improvement of outcomes. Comparisons of dependent variables, before and after the intervention, were analyzed using Wilcoxon Signed Rank Test.
             Results revealed that the program was feasible and acceptable. A significant improvement in outcomes, including health literacy scores, overall self-care behavior scores, and all seven dimensions of self-care behavior scores, occurred after the intervention (30 minutes per session, for four consecutive weeks). Findings suggest that the program is feasible and acceptable. However, whilst this program needs to be further tested using a randomized controlled trial, it has potential for nurses to promote health literacy and self-care behaviors of older people with chronic kidney disease receiving hemodialysis.

References

Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2021 [Internet]; 2021 [cited 2022 April 3]. Available from: https://www.cdc.gov/kidneydisease/pdf/Chronic-Kidney-Diseasein-the-US-2021-h.pdf

Thanakitcharu P, Bunnag S, Pichaiwong W. Chronic kidney disease: CKD: Thailand Medical Services Profile 2011–2014 [Internet]; 2014 [cited 2022 April 03]. Available from: https://www.hiso.or.th/hiso/picture/reportHealth/report/report8_9.pdf (in Thai)

Saritsiri S, Mongkolchati A, Suksaroj T. Prevalence of chronic kidney disease and related factors among diabetic patients in primary care, Bangkok, Thailand. J Pub Health Dev. 2021;19(1):1-18.

Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016; 23(1):19–28. https://doi.org/10.1053/j.ackd.2015.08.004

Kanjanabuch T, Takkavatakarn K. Global dialysis perspective: Thailand. Kidney 360. 2020; 1(7): 671-5. https://doi.org/10.34067/KID.0000762020

Thailand Renal Replacement Therapy Registry. Thailand renal replacement therapy: Years 2016-2019 [Internet];2019 [cited 2020 August 5]. Available from: https://www.nephrothai.org/wp-content/uploads/2021/01/1.TRT-Annual-report-2016-2019.pdf (in Thai)

National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884–930. https://doi.org/10.1053/j.ajkd.2015.07.015

Jain D, Green JA. Health literacy in kidney disease: review of the literature and implications for clinical practice. World J Nephrol. 2016;5(2):147–51. https://doi.org/10.5527/wjn.v5.i2.147

Nissenson AR, Fine RN, editors. Handbook of dialysis therapy. Elsevier; 2017.

Sousa CN, Marujo P, Teles P, Lira MN, Novais MELM. 2017. Self-care on hemodialysis: behaviors with the arteriovenous fistula. Ther Apher Dial. 2017;21(2):195–9. https://doi.org/10.1111/1744-9987.12522

Wong KK, Velasquez A, Powe NR, Tuot DS. Association between health literacy and self-care behaviors among patients with chronic kidney disease. BMC Nephrol. 2018;19(1):196. https://doi.org/10.1186/s12882-018-0988-0

Ramezani T, Sharifirad G, Rajati F, Rajati M, Mohebi F. Effect of educational intervention on promoting self-care in hemodialysis patients: applying the self-efficacy theory. J Educ Health Promot. 2019;65:1-8. https://doi.org/10.4103/jehp.jehp_148_18

Yang MM, Zhao HH, Ding XQ, Zhu GH, Yang ZH, Ding L, et al. Self-care behavior of hemodialysis patients with arteriovenous fistula in China: a multicenter, cross-sectional study. Ther Apher Dial. 2019; 23(2):167–72. https://doi.org/10.1111/1744-9987.12770

Naalweh KS, Barakat MA, Sweileh MW, Al-Jabi SW, Sweileh WM, Zyoud SH. Treatment adherence and perception in patients on maintenance hemodialysis: a cross–sectional study from Palestine. BMC Nephrol. 2017;18(1):178. https://doi.org/10.1186/s12882-017-0598-2

Kim S, Kim E, Ryu E. Illness perceptions, self-care management, and clinical outcomes according to age-group in Korean hemodialysis patients. Int J Environ Res Public Health. 2019;16(22): 4459. https://doi.org/10.3390/ijerph16224459

Rai D, Deenan A, Krungkraipetch N. Factors influencing self-management in end-stage renal disease (ESRD) patients undergoing hemodialysis in Bhutan. Thai Pharm Health Sci. 2019;14(1): 26–34 (in Thai).

Atashpeikar S, Jalilazar T, Heidarzadeh M. Self-care ability in hemodialysis patients. J Caring Sci. 2012;1(1):31–5. https://doi.org/10.5681/jcs.2012.005

Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072–8. https://doi.org/10. 1016/j.socscimed.2008.09.050

Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021 Apr 1; 42:159-73. doi: 10.1146/annurev-publhealth-090419-102529

Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000; 15(3):259–67. https://doi.org/10.1093/heapro/15.3.259

Chollou KM, Gaffari-fam S, Babazadeh T, Daemi A, Bahadori A, Heidari S. The association of health literacy level with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus: a cross-sectional study in Iran. Diabetes Metab Syndr Obes.

;13:1685-93. https://doi.org/10.2147/DMSO. S253607

Mahanupab P, Chintanawat R, Juntasopeepun P. Health literacy and self-management in older persons receiving hemodialysis. JTNMC, 2022;37(1):108-24 (in Thai).

Janchai N, Deoisres W, Chaimongkol N. Improving health literacy using the health education and health empowerment program in thai adults with uncontrolled hypertension: a randomized controlled trial. Pacific Rim Int J Nurs Res. 2021; 25(4): 600-613.

Arahung R, Hoontrakul S, Roojanavech S, The effects of health literacy enhancement program on hypertensive prevention behavior of pre-hypertension risk group at a community in Nakhon Pathom Province. J Royal Thai Navy Med. 2018; 45(3): 509-26 (in Thai).

Vorrapittayaporn C, Malathum P, Phinitkhajorndech N. Relationships among knowledge, health literacy, and health behavior in older persons with chronic kidney disease. Rama Nurs J. 2021; 27 (1): 81-95 (in Thai).

World Health Organization Regional Office for Europe. Health Literacy: The Solid Facts. [Internet]; 2008 [cited 2021April 6]. Available from: https://apps.who.int/iris/bitstream/handle/10665/128703/e96854.pdf.

Green JA, Mor MK, Shields AM, Sevick MA, Palevsky PM, Fine MJ, et al. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis. Clin J Am Soc Nephrol. 2011; 6(6):1354–60. https://doi.org/10.2215/CJN.09761110.

Taylor DM, Fraser SDS, Bradley JA, Bradley C, Draper H, Metcalfe W, et al. A systematic review of the prevalence and associations of limited health literacy in CKD. Clin J Am Soc Nephrol. 2017; 12(7):1070–84. https://doi. org/10.2215/CJN.12921216.

Shih CL, Chang TH, Jensen DA, Chiu CH. Development of a health literacy questionnaire for Taiwanese hemodialysis patients. BMC Nephrol. 2016;17(1):54. https://doi.org/10.1186/s12882-016-0266-y

Kuchinarai Crown Prince Hospital. Hemodialysis Unit Statistics 2019. Kalasin Province, Thailand: Kuchinarai Crown Prince Hospital; 2019 (in Thai).

Suramitrmaitree B. Improvement quality of health education to professional health literacy and health behavior development

[Internet]; 2015 [cited 2021April 6]. Available from:www.hed.go.th/news/file/123 (in Thai)

Choowong J, Sophonsuksatit J. Effects of health education on self-care behaviors of chronic renal failure with hemodialysis patients. J Health Sci Res. 2011;5(2):41-50 (in Thai).

Grove SK, Burns N, Gray JR. The practice of nursing research: appraisal, synthesis, and generation of evidence. St. Louis, Mo: Elsevier Saunders; 2012.

Lee S, Dajpratham P. Criterion validity of the Thai version of the PHQ-9 and the PHQ-2 for screening major depression in Thai elderly. J Thai Rehabil Med. 2017;27(1):30–7. doi: 10.14456/jtrm.2017.7 (in Thai).

Dharmasaroja PA, Charernboon T, Assanasen J, Dejthevaporn C, Limwongse C, Phantumchinda K. The correlation of Thai Mental State Examination (TMSE) and Montreal Cognitive Assessment (MoCA) and conversion table. J Med AssocThai. 2020;103(3):66.

Laohaprasitiporn P, Jarusriwanna A, Unnanuntana, A. Validity and reliability of the Thai version of the Barthel Index for elderly patients with femoral neck fracture. J Med Assoc Thai. 2017;100(5):539–48.

Thepin K, Moolsart S, Jantacumma N. Effectiveness of a health literacy developmental program in patients with uncontrolled hypertension. Boromarajonani Coll Nurs Uttaradit J. 2019;11(1):197–212 (in Thai).

Wungrath J, Mongkol P. Effectiveness of a health literacy enhancement program for caregivers of dependent older persons in a community of the northern part, Thailand. J Public Health Dev. 2020;18(2):24–36.

Saentecha P, Lamluk P. The effectiveness of a program for health literacy development in the patients with type 2 diabetes. Thai J Health Educ. 2020;43(2):150–64 (in Thai).

Wanprasert S, Moolsart S, Jantacumma N. The effectiveness of a health literacy developmental program in a pre-hypertension group with overweight. J Nurs Public Health Educ. 2019; 2(2):92–104 (in Thai).

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Published

2022-05-27

How to Cite

1.
Krit Boonasa, Ladawan Panpanit, Samoraphop Banharak, Nutda Kumniyom, Sutin Chanaboon. Literacy Enhancement Program among Older People Receiving Hemodialysis: Feasibility and Acceptability. PRIJNR [Internet]. 2022 May 27 [cited 2024 Nov. 22];26(3):474-87. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/258071