Impacto de uma intervenção educativa e motivacional para o controle da ingestão hídrica de pacientes em tratamento hemodialítico

Abstract

Introduction: The difficulty in controlling water intake reflected in the excessive interdialytic weight gain, and difficulty to achieve the goal of weight loss on hemodialysis session, is a problem in the care of patients with Chronic Kidney Disease who are undergoing hemodialysis therapy. Many patients have difficulties on comply with the prescription of liquids restriction and experience complications arising from water overload. Objective: To analyze the effect of an educational and motivational intervention to control liquids during the interdialytic period in chronic kidney disease patients who are undergoing hemodialysis therapy. Methods: This is a nonrandomized quasi-experimental clinical study. The participants were the terminal Chronic Kidney Disease patients who are undergoing hemodialysis therapy in a dialysis service in a city in the countryside of the State São Paulo. The participants have been enrolled into two groups: Control (n = 106) and Intervention (n = 86). For both groups, the patients had been interviewed by applying the clinical and sociodemographic characterization instrument, General and Perceived Self-Efficacy Scale (SOUZA; SOUZA, 2004), Confront Strategies Inventory of Lazarus and Folkman (SAVÓIA; SANTANA; MEJIAS, 1996), Resiliency Scale (PESCE et al., 2005) and Hospital Anxiety and Depression Scale (BOTEGA et al., 1995), at the beginning (T0) and at the end of study (T5). The study was conducted in six stages during five weeks of follow-up, and the intervention was performed by means of two meetings for the intervention sessions (T1 e T3) and two support meetings (T2 e T4). The intervention consisted of developing and implementing an educational and motivational video for liquids control, presented to patients. Also in the intervention, the support was carried out in two moments later for the guidelines follow-up. The percentage of weight lost was the variable research endpoint and featured the standard liquids consumption, measured on 16 measures of weight gain between dialysis sessions in the survey period, compared to ideal weight. Data have been analyzed through the statistical SAS 9.0 software and R program, version 3.4.1. Descriptive analysis had been conducted and linear regression templates have been proposed with mixed effects for comparisons between the groups and the times for the independent variables, and the inflated beta regression for analysis of associations between the independent variables and the endpoint variable. The project met the recommendations of CNS Resolution 466/2012, having been assessed and approved by two Research Ethics Committees with Human Beings, bound to the researchers and to the dialysis service under study, as well as registered in the Brazilian Clinical Trials Registration-ReBEC. Results: The study participants who are the patients with chronic kidney disease undergoing hemodialysis therapy at the end of study (T5), showed high levels of self-efficacy in

Content Analysis of the Diagnostic Proposition Risk of Excessive Fluid Volume in Hemodialysis Patients

“…Studies recommend the use of chewing gum to relieve xerostomia and thirst in these patients (25) . In addition, evidence indicates that the use of educational and motivational videos helps to control fluid intake, with a decrease in the interdialytic weight gain (26) .…”

Os Enfrentamentos Vivenciados Pelos Clientes Submetidos À Hemodiálise Sob a Ótica Do Modelo De Adaptação De Callista Roy Uma Revisão Integrativa

“…(8) Os diagnósticos de enfermagem ligados a DRC e aos problemas adaptativos relacionados neste estudo são: excesso de volume hídrico relacionado ao processo da doença; nutrição alterada (restrição dietética e hídrica); risco de lesão durante deambulação e atividades que se relaciona às fraquezas potenciais e anemia; não-complacência com o regime terapêutico relacionada às restrições impostas pela DRC e o tratamento. (9) A etapa seguindo do processo de enfermagem proposto por Roy é o estabelecimento de metas para que a intervenção seja realizada. As metas serão as estratégias utilizadas pelo enfermeiro para atuar na intervenção, que tem como objetivo manter e aumentar o comportamento adaptável e modificar o comportamento ineficaz tornando-o adaptável.…”