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Bowornjit Maytharit. The Effectiveness of the nutritional promotion program on nutritional status and quality of life of patients undergoing hemodialysis. Doctoral Degree(). Chiang Mai University. Library. : Chiang Mai University, 2025.
The Effectiveness of the nutritional promotion program on nutritional status and quality of life of patients undergoing hemodialysis
Abstract:
Chronic kidney disease (CKD) presents a significant global public health challenge, with hemodialysis (HD) serving as a vital therapeutic approach for patients with end-stage renal disease (ESRD). Nevertheless, malnutrition remains a common complication among HD patients, adversely affecting their overall health status, clinical outcomes, and quality of life. This study aimed to examine the effects of the nutritional promotion program on the nutritional status and quality of life of patients undergoing hemodialysis at Sakon Nakhon province, Thailand. A quasi-experimental design with a control group and an experimental group was employed. The sample consisted of 110 participants, with 55 in each group. The experimental group received a 12-week nutritional promotion program based on the self-management concept of Creer (2000). The intervention included individual face-to-face education sessions, educational content delivered through the LINE application, tele-counseling, and group discussions, while the control group received standard care. The instruments used to assess outcomes included the food consumption knowledge questionnaire, food consumption behavior questionnaire, nutrition alert form, and the Kidney Disease Quality of Life-Short Form (KDQOL-SF™), version 1.3. Group differences in baseline demographic characteristics and study outcomes were examined using Chi-square tests and independent t-tests. ; A repeated measures ANOVA was conducted to assess the effects of the nutritional promotion program over time (baseline, week 12, and week 16). ; The results indicated no significant differences in demographic characteristics or in the baseline mean scores of food consumption knowledge, food consumption behavior, nutritional status, and quality of life between the control and experimental groups. The experimental group showed significant improvements in food consumption knowledge (p = 0.001), food consumption behavior (p = 0.016), and quality of life (p < ; 0.001) across time points, whereas no statistically significant improvement was observed in nutritional status. These findings suggest that nutritional promotion programs based on the self-management concept of Creer (2000), incorporating digital technologies such as the LINE application in combination with tele-counseling and group discussions, can effectively enhance food consumption knowledge, improve food consumption behavior, and promote the quality of life among patients with ESRD undergoing hemodialysis.