Effects of a supportive and educational nursing program on dietary and nutritional behaviors Clinical outcomes of the elderly with chronic kidney disease stage 3-4 at the Kidney Disease Clinic, Tha Tako Hospital

Abstract

              This was quasi-experimental research aimed to examine the effects of supportive education nursing programs on food consumption behaviors and clinical   outcomes among  Chronic  Kidney  disease  elderly  stage  3-4, Kidney Clinic,  Thatako  Hospital.  Level among sixty CKD elderly  stage 3-4, who  visited  the  CKD  elderly  stage  3-4  clinic  at  Thatako  Hospital.  Data were collected  from  11 October to  02 December 2022.  The  subjects  were purposively  selected  based on the  inclusion criteria  and were  randomly assigned in  equal  numbers  into  experimental  and  control  groups  with thirty cases in each group.  The  similarity between groups in  terms of sex, age,  income,  length  of illness with  CKD,  glomerular  filtration rates,  and blood  pressure  level.  The  subjects  in  the  experimental  group  received a  supportive    education   nursing   program   from   the   researcher.   The conceptual model used in this study was Orem's Nursing Theory. While the control group received  the usual  nursing care.  The research instruments  consisted of a  supportive education nursing  program, a handbook of food consumption  for  CKD  elderly  stage  3-4,  a Demographic  Data  Recording Form,   Food  consumption  behavior,   and   clinical  outcomes.  Data  were analyzed using descriptive statistics and inferential statistics by paired-test and independent t-test.

            Results revealed that after the intervention, the experimental group had  significantly  higher mean scores of food  consumption  behaviors for CKD elderly stage  3-4 than before the  intervention  and  had  significantly higher  than  the   control  group  (p  <  0.05).   For  clinical  outcomes,   and estimated glomerular  filtration rates,  the  experimental  group  showed  a better  filtering  rate of the  kidney  than before  the  intervention  and  the control  group,  but not  statistically  significant  (p = 0.10) Additionally,  the experimental group had significantly lower mean scores of blood pressure than  before   intervention  and had  significantly  lower  than  the  control group (p< 0.05).

              The results from this study  indicate that the  supportive  education nursing  program  could  have  good  effects  to increase food  consumption behaviors and control clinical outcomes for CKD elderly stage 3-4. It can be used for improving  the  quality  of care in  Kidney  Clinics  and  nurses can use this program to guide the care the patients  with CKD elderly  stage  3-4 to effectively  care  for  food  consumption  management  and a  supportive - education  system  for reducing  waste  products  which will  help  reduce the decline of kidney function.  Therefore, implementation of this program is suggested  to  improve  its  effectiveness of this program with monitoring and  evaluation  of  the  glomerular  filtration  rate  at  4,  8  and  12 months adding  add a  variable  follow-up,  such  as the  amount  of  sodium  in  the urine and  24-hour urine  protein to  assess the  effect of the  patient’s  diet, protein and sodium salt diet.