The effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions in elderly hemodialysis patients with low baseline health literacy.

INTRODUCTION

Adherence to renal dietary restrictions is an important method for minimizing complications in dialysis patients. This study aimed to investigate the effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions among elderly hemodialysis patients in Iran. Selected markers of diet and kidney function were also measured.

METHODS

Sixty-nine elderly hemodialysis patients with a low level of health literacy were randomly divided into three groups: pictorial image education, teach-back education, and usual care (controls). The intervention groups received diet education comprising four 20-30 min sessions. Subsequently, nutrition knowledge was assessed in each of the three groups by questionnaire before and 2 months after the intervention. Blood laboratory indices were obtained from the patients' medical records and compared before and 2 months after the educational intervention.

FINDINGS: There were significant differences in the mean nutritional knowledge scores between the two intervention groups and the controls (p < 0.001). Nutrition knowledge scores were higher after educational sessions incorporating images compared to those using a teach-back strategy.

DISCUSSION: Nutrition educational strategies utilizing either pictorial images or teach-back techniques increased knowledge relating to renal nutrition.