JMIR Nursing · Published 2026-06-17 · DOI 10.2196/94330
Yu Shi, Hongmei Peng, Youying Zhang, Jingyu Zhang, Yang Li, Shi Pu, Xiangchun Tang, Jinghong Zhao
Abstract BackgroundDigital interventions can support sodium restriction in chronic kidney disease; yet, implementation and engagement barriers remain poorly understood. ObjectiveThis mixed methods study evaluated a nurse-led digital program for sodium restriction, focusing on 3 key aspects: implementation, engagement, and patient experience. MethodsThis study was initially designed as a randomized controlled trial but was revised to a mixed methods implementation study due to high rates of missing primary outcome data. Quantitative measures included 24-hour urinary sodium excretion (the primary outcome of the original randomized controlled trial), knowledge tests, blood pressure measurements, and quality-of-life assessments. Concurrently, we conducted in-depth qualitative interviews with a purposive sample of participants. Quantitative and qualitative data were collected in parallel, analyzed separately, and then integrated to provide a comprehensive understanding of participants’ experiences with the intervention. ResultsAmong 99 enrolled patients (46 in the enhanced digital intervention group and 53 in the minimal digital control group), the program led to a significant improvement in sodium-related knowledge as a secondary exploratory outcome (P ConclusionsA nurse-led digital intervention was associated with modest improvements in sodium knowledge in chronic kidney disease. However, success requires reducing the monitoring burden and improving real-world fit. The “measurement paradox” highlights the need for patient-centered outcome measures. We propose a “stage-matched intervention” framework to guide adaptive digital tools. Future research should prioritize multicenter pragmatic trials to bridge the knowledge-action gap.
Abstract from DOAJ. Public domain (CC0 1.0).
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Shi, Y., Peng, H., Zhang, Y., et al. (2026). Nurse-Led Digital Intervention for Sodium Restriction in Chronic Kidney Disease: Mixed Methods Implementation Study. JMIR Nursing. https://doi.org/10.2196/94330