Educational support programs for individuals with end-stage renal disease on hemodialysis: a scoping review

The global prevalence of End-Stage Renal Disease (ESRD) is increasing, with estimates suggesting that more than 5 million people worldwide require renal replacement therapy (RRT), and this burden falls disproportionately on low- and middle-income countries (LMICs), highlighting the urgent need for effective strategies to support patient self-management. This scoping review synthesizes evidence on the types, delivery methods, and reported outcomes of educational support programs for individuals with ESRD undergoing hemodialysis (HD).

This review followed the six-stage methodological framework by Arksey and O'Malley and adhered to the PRISMA Extension for Scoping Reviews guidelines. Studies examining educational interventions for ESRD patients on HD were included. A comprehensive search of MEDLINE, CINAHL, Scopus, PubMed, and Web of Science was conducted for English-language articles published between 2011 and 2021. Search terms included combinations of "end-stage renal disease," "ESRD," "hemodialysis," and "haemodialysis" with "educational program," "support program," "patient education," and related terms. Pairs of reviewers independently screened titles and abstracts and assessed full-text articles, resolving discrepancies through group discussion. Data were extracted using a standardized form capturing key study characteristics and synthesized using descriptive statistics and content analysis.

Eighteen studies (n = 18) from ten countries met the inclusion criteria. All studies reported that educational interventions, regardless of delivery mode or design, positively influenced quality of life (QOL) and treatment adherence among ESRD patients. Specifically, improvements were documented in serum phosphate control, intradialytic weight gain, psychological well-being (anxiety, depression, stress), self-esteem, dietary knowledge, and physical functioning. Structured self-management programs, particularly those incorporating nutritional education and psychological support, demonstrated the greatest breadth of benefit across clinical and psychosocial domains.

This review maps the evidence on educational support programs for HD patients, revealing variability in intervention types, delivery methods, study designs, and outcome measures. These inconsistencies highlight the need for more rigorous, standardized research particularly in LMICs to determine the most effective educational strategies. The findings provide a foundation for developing evidence-based, patient-centered educational programs adaptable to diverse global populations.