Improving adherence to femoral non-tunnelled dialysis catheter care with health belief model-based education pamphlets among individuals receiving haemodialysis.

BACKGROUND

Patients with femoral non-tunnelled dialysis catheters (NTDC) are at risk of mechanical complications such as kinking, accidental dislodgement and fatal exsanguination. There is currently no standardised education provided on femoral NTDC care. This may lead to poor adherence to care guidelines and compromise patient safety.

OBJECTIVES

To compare the effectiveness of non-standardised verbal education and a Health Belief Model-based patient education pamphlet (HBM-PEP) in improving adherence to catheter care among patients receiving haemodialysis.

DESIGN

A single centre pre- and post-implementation study.

PARTICIPANTS

Individuals receiving haemodialysis via femoral NTDC.

MEASUREMENTS: Patients' knowledge of, beliefs about, perceived adherence and actual adherence to femoral NTDC care were assessed using a 29-item questionnaire, nursing handover reports and adherence charts.

RESULTS

One hundred participants were recruited, with 50 receiving non-standardised verbal education and the other 50 receiving standardised education through HBM-PEP. Perceived adherence (p = 0.006) and actual adherence (p = 0.001) significantly improved after the pamphlet intervention. Knowledge positively correlated with both perceived (r = 0.226) and actual adherence (r = 0.227, p = 0.023). A moderate correlation was observed between perceived and actual adherence (r = 0.543, p < 0.001). The duration of femoral NTDC in situ (B = -9.18, p = 0.002), moderate level of assistance (B = 1.15, p = 0.037), perceived knowledge (B = 0.44, p = 0.009), perceived adherence (B = 1.16, p < 0.001) and use of PEP (B = 0.82, p = 0.025) were significant predictors of actual adherence.

CONCLUSION

The HBM-PEP improved knowledge and adherence to femoral NTDC care, highlighting the value of standardised education in promoting safer patient behaviour given the risk of severe mechanical complications.