Efeito da intervenção educativa na adesão ao tratamento da hemodiálise em pessoa com doença renal crônica: evidências para a assistência

Abstract

Chronic kidney disease has a high incidence and high morbidity and mortality rates, and adherence to treatment by people affected by the disease is of great importance for maintaining quality of life and promoting health. This study aimed to evaluate the effect of an educational intervention on adherence to hemodialysis treatment in people with chronic kidney disease at a general hospital in a city in the south of Minas Gerais. To conduct this research, three stages were carried out. The integrative review used a methodological framework, was registered in the Open Science Framework and used five sources of information. The methodological research was used to construct an educational material and its content validation by seven judges and using the Delphi technique and the Content Validation Index. The quasi-experimental research was carried out with 142 people undergoing hemodialysis in a center in the south of Minas Gerais. Validated instruments were used before and after the intervention, and the intervention was carried out at the time of hemodialysis, with presentation and explanation of the content of the booklet. Data analysis was performed using statistical tests, and the project was approved by the Research Ethics Committee. The integrative review included six studies and the following categories emerged: nutrition/diet, self-care and blood pressure control, physical activity, breathing practices for mental health, and use of calcium medication. The methodological stage resulted in the production of the educational booklet “Learn more about how to adhere to hemodialysis treatment”. This booklet was approved by all judges, with a final Content Validation Index of one, and this material was registered in the “Copyright Registration – AutoriaFacil.com” system. The quasi-experimental stage had the following main results: participation of 142 people in the first stage (pre-intervention) and 130 in the third stage (postintervention), the majority of whom were male, aged 60 to 69, Catholic, with an income of up to 1,500.00 BRL, married/in a stable union. Regarding adherence itself, participants presented high averages in the four domains of the adherence instrument (hemodialysis, medication, fluid restriction and diet). Each domain was associated with independent variables: hemodialysis domain with four independent variables, medication domain with three, fluid restriction domain with nine and diet adherence domain with 11 independent variables. When comparing the averages of the adherence domains before and after the educational intervention, it was observed that only the medication domain had a statistically significant difference, showing that the average increased after the intervention; however, it is noteworthy that, although the other three domains did not present a statistically significant difference, the averages also showed an increase after the intervention. It is concluded that using actions that involve health education, with the support of strategies and resources such as the booklet, are an important aid to improving knowledge and practices of adherence to hemodialysis treatment.