Implementing a Culturally Sensitive Fluid and Dietary Educational Intervention in an Outpatient Dialysis Center

Chronic renal failure is characterized by a gradual, irreversible kidney dysfunction that often leads to end-stage renal failure. Hemodialysis (HD) is the most prevalent method of removing fluid and uremic toxins from patients with end-stage renal disease (ESRD). Successful HD treatment outcomes depend on patient adherence to treatment regimen to reduce the risks of symptoms and medical complications and to restore quality of life. However, compliance with fluid and dietary restrictions remains a problem among HD patients. This project implemented an effective, culturally sensitive fluid and dietary educational program in an outpatient dialysis center. The sample size of 17 participants consisted of 8 males and 9 females from various racial backgrounds. The patients ranged in age from 40 to 85 years. Other demographic information collected included years on dialysis, educational backgrounds and work status. Pre and post test results indicated increased in knowledge in all participants. There were however, no significant correlations between patients’ demographic characteristics and change in test scores. Qualitative comments reflected various themes including: conflicting dietary messages for participants with multiple chronic diseases, need for family involvement and limited knowledge of culturally appropriate renal foods. These findings have implications for clinical practice including modifying generic educational interventions to reflect the culture of patients, and providing ongoing educational opportunities for nephrology nurses so they are better equipped to provide nutritional information to their patients. Key Words: Chronic Renal Failure, fluid restrictions, culturally sensitive care, hemodialysis fluid and dietary restriction