Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon.

Mirey Karavetian, Nanne de Vries, Hafez Elzein, Rana Rizk, Fida Bechwaty

Journal: Patient education and counseling 2018;98(9):1116-22

PMID: 26070468

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

Assess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients.

METHODS

Randomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88). Cluster 2 patients (n=210) received nutrition education from general hospital dietitians, educating their patients at their spare time from hospital duties. Main outcomes were: (1) dietary knowledge(%), (2) behavioral change, (3) serum phosphorus (mmol/L), each measured at T0 (baseline), T1 (post 6 month intervention) and T2 (post 6 month follow up).

RESULTS

Significant improvement was found only among patients receiving intensive education from a dedicated dietitian at T1; the change regressed at T2 without statistical significance: knowledge (T0: 40.3; T1: 64; T2: 63) and serum phosphorus (T0: 1.79; T1: 1.65; T2: 1.70); behavioral stages changed significantly throughout the study (T0: Preparation, T1: Action, T2: Preparation).

CONCLUSION

The intensive protocol showed to be the most effective.

PRACTICE IMPLICATIONS

Integrating dedicated dietitians and stage-based education in hemodialysis units may improve the nutritional management of patients in Lebanon and countries with similar health care systems.

Address: Maastricht University, Maastricht, 6200 MD Maastricht, The Netherlands. Electronic address: [email protected].; Maastricht University, Maastricht, 6200 MD Maastricht, The Netherlands. Electronic address: [email protected].; Lebanese National Kidney Registry, Beirut, Lebanon. Electronic address: [email protected].; Maastricht University, Maastricht, 6200 MD Maastricht, The Netherlands. Electronic address: [email protected].; Université Saint Joseph, Beirut, Lebanon. Electronic address: [email protected].

DOI: 10.1016/j.pec.2015.05.005

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MeSH Terms: Chronic Kidney Disease-Mineral and Bone Disorder, Counseling, Diet, Disease Management, Feeding Behavior, Health Education, Humans, Lebanon, Nutritionists, Phosphorus, Renal Dialysis