Evaluation of the effect of the PRECEDE PROCEED model-based education program on hemodialysis patients' treatment compliance, healthy lifestyle behaviors, and quality of life.

BACKGROUND

Improving health-promoting lifestyle behaviors, treatment adherence, and quality of life is important for patients undergoing hemodialysis. This study aimed to evaluate the effects of a PRECEDE-PROCEED model (PPM)-based educational program on health-promoting lifestyle behaviors, treatment adherence, and quality of life among patients undergoing hemodialysis.

METHODS

This study employed a controlled pretest-posttest-follow-up design to evaluate a community-based educational program developed using the PPM. Patients were assigned to either an intervention group (n = 34) or a control group (n = 32) according to their hemodialysis treatment schedules to minimize contamination between groups. The primary outcome was health-promoting lifestyle behaviors measured using the healthy lifestyle behaviors scale II (HLBS-II). Secondary outcomes included treatment adherence and quality of life. Data were collected using the MARS, FCHPS, SDBHP, HLBS-II, and SF-12 scales and analyzed using linear mixed-effects models.

RESULTS

Significant group × time interaction effects were identified for HLBS-II total scores, medication adherence, dietary behaviors, fluid control behaviors, and quality-of-life scores in favor of the intervention group (P < .05). The intervention group demonstrated significant improvements in health-promoting lifestyle behaviors, particularly in health responsibility, physical activity, stress management, and interpersonal relations. Improvements in both physical and mental quality-of-life scores were also observed following the intervention.

CONCLUSION

The findings suggest that a PPM-based educational program may improve health-promoting lifestyle behaviors, treatment adherence, and quality of life among patients undergoing hemodialysis. These results support the use of theory-based educational interventions in hemodialysis care.