Proposed Project Interventions
For chronically ill patients, continuous medication and adherence to provider instructions are some of the practices that becomes part of the patient’s lifestyle. Accordingly, there is need for information transmission from healthcare service providers to patients to foster discipline to medication regimes. One of such conditions is chronic renal disease, which requires patients to be continuously under medication. However, one of the challenges involved in dealing with such a condition is that patients may fail to adhere to their medication regimes. Educational intervention for patients with end stage renal disease can help in improving knowledge among the patients and subsequently improving their capacity for self-care. In a study by Lopez-Vargas, Tong, Howell, and Craig (2016),it was discovered that patients’ self-care may be limited due to lack of knowledge and understanding of the conditions affecting them. Therefore, educational interventions can help in the dissemination of knowledge and improved self-care capability.
Factors Influencing the Use of Educational Interventions
Interventions in end stage renal disease conditions are aimed at fostering self-care. According to Donald et al. (2018), a wide range of interventions are available for self-management among patients with renal diseases. Variable interventions result in varied outcomes, which also demand on the level of patient involvement in the intervention design phase. Some of the interventions do not stem from the consultations between patients’ and their doctors/caregivers resulting in poor improvements in patient outcomes. Additionally, Donald et al. suggest that many directions can be used in developing patient interventions through applying behavioral change theory. Patients can be involved in co-developing and evaluating a self-management intervention based on clinical evidence. Educational intervention, like other interventions that are co-developed by the patients, result in positive outcomes in terms of self-care improvement (Peng et al., 2019).
Murali et al. (2019) describe various factors that are associated with interventions in end stage renal diseases. Particularly, the authors mention factors such as the types of interventions that can be used in promoting self-management among patients with chronic diseases, the frequency of non-adherence to medication among such patients, the intended outcomes of selected interventions. When choosing the right interventions for chronic conditions such as end stage renal disease, the objective is to improve the capacity of the patients for self-care, which include adherence to diet recommendations, recommended fluid intakes, recommended medication dosages, and recommendations on dialysis frequencies (Murali et al., 2019). One of the factors that have been mentioned as inhibitive to self-care among patients with end stage renal disease is theabsence of standardized approaches for patient adherence to various practitioner recommendations. Through patient education, it may be possible to improve the ability of patients to take care of their primary needs even without standardized methods.
D’Souza, Prabhu, Unnikrishnan, and Kamath (2018) explore the common characteristics associated with patients of end stage renal disease. One of the issues mentioned is malnutrition, which was attributed to several factors including lack of information about dietary requirements and poor appetite. While the discussed barriers prevent patients from living their lives optimally, they could be alleviated through proper education and pharmacological interventions. However, there are other barriers that prevent such patients from accessing educational programs associated with the condition. Accordingly, D’Souza et. al report that patient providers and system factors, limited health literacy, unwillingness to learn, communication challenges, and lack of working interdisciplinary care models, contribute significantly to poor patient education among patients with end stage renal disease. Additionally, poor access to information and time constraints also act as barriers to patient education. Each of these barriers could be alleviated by improving the status of knowledge sharing within the healthcare system, to ensure that healthcare providers have the right information needed by the patients. The nurses in particular, spend a lot of time with patients suffering from chronic conditions such as end stage renal disease, and should be equipped with sufficient knowledge to pass through to those patients.
Healthcare providers would need various resources to ensure they deliver patients’ education successfully. Educational interventions would cover a wide scope of activity including dietary trainings and fluid restriction education, exercise training, medication adherence training, quality of life and self-management trainings. For these educational interventions to be successful, the providers would need educational materials including information charts on nutrition, end stage renal disease, exercise, self-management, and medication adherence among patients. Additionally, the providers would need time since time constraint is mentioned as one of the barriers to patient education. Financial resources would also be necessary to foster communication through presentations, organized focus group counseling sessions and individual counseling sessions. For any provider, the intervention process should begin with grouping patients into different categories based on the extent of their illness. Secondly, there would be trainings and awareness creation among healthcare providers to ensure they are well-equipped to educate patients. The patient groups would then be assigned to specific educators who would schedule meetings with them. Various sessions would be required to pass all the information required to patients.
Through the trainings, the providers would also carry out a process of continuous tracking, monitoring, and ongoing review for the patient progress. Monitoringpatients would involve the use of questionnaires to determine the knowledge gaps in patients and developing strategies to cover those gaps. Continuous evaluation would be possible since people who have end stage renal disease have long term relations with their providers. The providers (specifically nurses), will be responsible for obtaining resources, patient education, monitoring and evaluation. The intervention can be implemented and closely monitored over a 5 month period and is expected to result in improved adherence to medication recommendations as described by D’Souza et al. (2018).
Patients suffering from end stage renal disease require constant monitoring. Interventions that improve their capacity for self care therefore, are essential for better health outcomes. Considering the need for self management improvement, patient education has been proposed as an intervention for end stage renal disease since one of the barriers to effective self management is lack of knowledge. Education patients will result in improved health outcomes through better adherence to medication, nutritional recommendations and lifestyle changes.
Donald, M., Kahlon, B.K., Beanlands, H., Straus, S., Ronksley, P., Herrington, G., Tong, A., et al. (2018). Self-management interventions for adults with chronic kidney disease: a scoping review. BMJ Open, 8. Retrieved from bmjopen.bmj.com/content/bmjopen/8/3/e019814.full.pdf
D’Souza, B., Prabhu, R., Unnikrishnan, B., & Kamath, J. (2018). Effect of multidimensional educational interventions among dialysis patients. The Open Urology & Nephrology Journal, 11: 72-78. Retrieved from openurologyandnephrologyjournal.com/VOLUME/11/PAGE/72/FULLTEXT/
Lopez-Vargas, P.A., Tong, A., Howell, M., & Craig, J.C. (2016). Educational interventions for patients with CKD: A systematic review. American Journal of Kidney Diseases, 68(3): 353- 370. Retrieved from www.ncbi.nlm.nih.gov/pubmed/27020884
Murali, K.M., Mullan, J., Roodenrys, S., Hassan, H.C., Lambert, K., & Lonergan, M. (2019). Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials. PLoS One, 14(1). Retrieved from journals.plos.org/plosone/article?id=10.1371/journal.pone.0211479
Peng, S., He, J., Huang, J., Lun, L., Zeng, J., Zeng, S., Zhang, L., et al. (2019). Self-management interventions for chronic kidney disease: a systematic review and meta-analysis. BMC Nephrology, 20(142). Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC6486699/#__ffn_sectitle