Dietary Knowledge, Health Belief, and Practice Among Hemodialysis Patients: A Structural Equation Modeling Study

To develop a structural equation model to investigate the correlation between dietary knowledge, health belief, and practice in hemodialysis patients.

A multicenter cross-sectional study was conducted with 558 hemodialysis patients. The dietary knowledge and practice questionnaire and the dietary health belief questionnaire (including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy) in hemodialysis patients were used to collect data. Multiple linear regression analysis was used to explore the independent influencing factors of dietary practice scores. Structural equation modeling was utilized to analyze the relationships between dietary knowledge, health belief, and practice in hemodialysis patients.

Multiple linear regression analysis suggested that female gender (β = 0.147, P < .001), lower perceived susceptibility score (β = -0.103, P = .021), higher perceived benefits scores (β = 0.230, P < .001), lower perceived barriers scores (β = -0.118, P = .007), and higher self-efficacy scores (β = 0.253, P < .001) were associated with a higher dietary practice score. The structural equation model showed significant relationships between dietary knowledge and perceived severity (β = 0.736, P = .002), perceived benefits (β = 0.858, P = .001), and self-efficacy (β = 0.433, P = .001). Dietary practice was significantly linked to perceived barriers (β = -0.184, P = .001). The R² value for dietary practice in the structural equation model was 22.6%.

Dietary educational interventions should focus on boosting self-efficacy and perceived benefits while minimizing perceived barriers to enhance dietary adherence in dialysis patients.