PREDIALYSIS PATIENT EDUCATION - EFFECTS ON FUNCTIONING AND WELL-BEINGIN UREMIC PATIENTS

This study evaluated the effects of a predialysis patient education pr ogramme on functioning and well-being in 28 uraemic patients. The prog ramme consisted of four group sessions with the following themes: rena l disease and dietary restriction, active renal replacement therapy, p hysical exercise, and the impact of chronic renal failure on economy, family and social life. Three to 9 months after having started dialysi s the patients were evaluated regarding symptoms, perceived health (He alth Index), functional (SIP) and emotional (STAI) status. Twenty-eigh t patients already on dialysis treatment informed according to convent ional routines constituted the comparison group. There were no signifi cant differences between the groups regarding age, sex, educational or social background, duration of kidney disease, choice of dialysis tre atment, cause of renal disease and laboratory tests except for s-urea. The patients who participated in the education programme scored signi ficantly better mood, less mobility problems (HI), less functional dis abilities (SIP) and lower levels of anxiety (STAI) compared to the com parison group. There were no significant differences between the two g roups regarding symptoms and overall health. The differences between t he groups prevailed during the first 6 months on dialysis treatment, a fter which the differences disappeared. In the comparison group age co rrelated significantly to anxiety and overall SIP, which was not the c ase in the experimental group. In conclusion, the experimental group t hat participated in a predialysis patient education programme, showed better functional and emotional well-being than the non-educated compa rison group. The positive effects of participating in an education pro gramme prevailed during the first 6 months of dialysis treatment. More over, the younger patients seemed especially to benefit from participa tion in a predialysis patient education programme. It is suggested tha t patient education should be ongoing for patients with end-stage rena l failure initiated during the predialysis stage and continued after m aintenance dialysis has been established.