Self-Efficacy and Compliance Fluid Intake Restriction as a Determinant of The Interdialytic Weight Gain (IDWG) Level

Abstract

Higher interdialytic Weight Gain (IDWG) is commonly experienced by patients with chronic kidney disease (CKD). Increased IDWG can cause various complications that result in risk of death. CKD patients who had undergoing hemodialysis in the Public Regional Hospital of Indramayu would have different weight gain, but it is not known what factors affect the increase in IDWG. The purpose of this study was to determine the factors that were significantly related to the IDWG level in CKD patients in the Public Regional Hospital of Indramayu. This research design is descriptive-analytic. The number of samples was 86 respondents who were selected by consecutive sampling technique. Data collection tools are questionnaires and the data analysis technique is the Pearson chi-square test. From the result from 86 respondents, it is known that 44 (51.2%) respondents experienced an increase in IDWG level at the mild category (<4%). It is known that the factor influencing to level of IDWG are self-efficacy (p-value = 0.000; 95% CI) and fluid intake compliance (p-value = 0.042; 95% CI). Meanwhile, age, sex, education level, family support, and duration of hemodialysis are not influencing the IDWG level (p-value > 0,05; 95% CI). Self-efficacy and fluid intake compliance are the most significant factor on the IDWG level in CKD patients who had hemodialization. Patients with high self-efficacy can reduce the IDWG level accompanied by compliance with fluid restriction. Recommendation for hemodialysis nurses needs to increase the patient’s self-efficacy in limiting fluid so that can be controlled at the IDWG level.

Relationship between self-efficacy and interdialytic weight gain (IDWG) index in people with chronic renal failure

“…Bayhakki et al (2017) stated that the longer the patient undergoes HD therapy, the more opportunities the patient will have to adapt to the therapy program. Likewise, new patients undergoing HD therapy tend to be maladaptive to the therapy program they are undergoing; new patients have a high potential for violations such as diet rules because they are not used to it, which hinders compliance with the therapy program [12], [16], [17], [22], [24].…”

“…Weight gain in CKD patients will always occur because the kidneys fail to remove metabolic waste in the form of water, electrolytes, and other metabolic waste. IDWG is considered a measure of patient compliance when undergoing hemodialysis therapy [16]. Improvements in IDWG that are too high can cause negative effects on the body, including hypotension, muscle cramps, shortness of breath, nausea, and vomiting [20] Restricting fluid intake in chronic kidney failure patients undergoing hemodialysis is an important thing to pay attention to because excessive fluid intake can cause weight gain, edema, fluid accumulation in the lungs, swollen eyelids, and shortness of breath due to excess fluid volume.…”

“…This is related to the level of self-efficacy of each patient. The higher the self-efficacy, the more the patient's awareness of carrying out selfmanagement will increase [11], [14], [16], [22].…”

Hemodiyaliz Tedavisi Alan Bireylerde Sıvı Kontrolüne Uyum ile Hastalık Semptomları Arasındaki İlişkinin İncelenmesi

“…Fazla ultrafiltrasyon (UF) miktarı hastaların diyaliz süresinde kramp, baş dönmesi, hipotansiyon, bulantı-kusma göğüs ve baş ağrısı gibi belirtiler yaşayarak diyaliz seansının erken sonlanmasına neden olmakta ve diyaliz sonrasında ise hastalar yorgunluk, uyku problemleri ve baş dönmesi gibi şikayetlerle baş etmek zorunda kalmaktadırlar (19,24). Çeşitli araştırmalar iki diyaliz arası dönemde hastaların %60-80'inin fazla sıvı alması nedeniyle hayatlarını kaybettikleri saptanmıştır (25). Bu araştırma hastaların sıvı kontrolüne uyum ile hastalarda hastalık semptomları arasında ilişkiyi inceleyen ilk çalışmadır.…”