The Effectiveness of a Self-Management-Based Nutritional Promotion Program on Food Consumption Knowledge, Behaviors, and Quality of Life of Patients Undergoing Hemodialysis

Abstract

Background: Patients undergoing hemodialysis (HD) often experience food consumption and nutritional challenges that affect their health outcomes and quality of life (QoL). Traditional nutritional education alone may be insufficient to promote sustainable behavioral change. The self-management concept, which emphasizes patients’ active involvement in managing their health, has been insufficiently applied among HD patients in Thailand. Purpose: This study evaluated the effectiveness of a nutritional promotion program in improving the QoL of HD patients, based on the self-management concept of Creer (2000). Methods: A quasi-experimental design was employed with 110 HD patients recruited from two dialysis centers in Sakon Nakhon Province, Thailand. Participants were equally allocated to experimental (n = 55) and control (n = 55) groups. The experimental group received a 12-week nutritional promotion program based on the self-management concept of Creer (2000), which consisted of individual face-to-face education, group-based educational content via the LINE application, individualized tele-counseling, and group discussions, while the control group received standard care. Data were collected using the Kidney Disease Quality of Life-Short Form (KDQOL-SF™), version 1.3, and analyzed using descriptive statistics and repeated measures ANOVA. Results: The results indicated no significant differences in demographic characteristics or baseline mean QoL scores between groups. The experimental group showed significant improvements in food consumption knowledge, food consumption behaviors, and QoL (p < 0.05) across time points compared with the control group. Conclusion: The nutritional promotion program grounded in Creer’s (2000) self-management framework, integrating individualized education, structured group-based LINE content, individualized tele-counseling, and group discussions, effectively improved food consumption knowledge, food consumption behaviors, and QoL in HD patients. The program strengthened patients’ capacity for self-regulation of food consumption behaviors and enhanced their overall well-being. These findings underscore the potential of hybrid, self-management-based nutritional interventions as a patient-centered approach to improving key outcomes in HD care.