Construction of a home-based dietary self-management intervention program for maintenance hemodialysis patients based...

Effective dietary self-management behaviors can mitigate complications, enhance quality of life, and prolong survival in patients undergoing maintenance hemodialysis (MHD); however, factors inherent to both the dialysis process and the underlying disease often result in poor adherence to prescribed treatment diets and a high incidence of malnutrition. Based on the IKAP (Information-Knowledge-Attitude-Practice) theory and a collaborative care model, a home-based dietary self-management intervention program for MHD patients was designed through literature review, focus group interviews, and semi-structured interviews. The Delphi method was then used to consult 15 experts from departments of nephrology and nutrition via questionnaires. After adjustments, the final version of the intervention program for MHD patients was determined. Two rounds of expert questionnaires were administered, both with a 100% effective recovery rate; the experts' authority coefficient was 0.87. Kendall's coefficients of concordance for the two rounds of expert consultation ranged from 0.238 to 0.394 (all P < 0.05). Ultimately, an intervention program based on the IKAP theory and collaborative care model for MHD patients was developed, comprising 4 primary items, 4 secondary items, and 24 tertiary items. The home-based dietary self-management intervention program for MHD patients based on the IKAP collaborative care model achieved good expert recognition. However, further empirical studies are needed to validate the program.