Journal of Integrative Nursing · Published 2026-04-01 · DOI 10.4103/jin.jin_26_26
Objective: To develop and evaluate the effectiveness of a holistic, theory-based nurse-led intervention designed to address multidimensional stressors and enhance self-efficacy and quality of life among patients undergoing maintenance hemodialysis. Materials and Methods: A sequential exploratory mixed-methods design was conducted in two tertiary government hospitals in India. Phase I involved phenomenological interviews (n = 12) to explore lived experiences and stressors; findings guided the development of a structured nurse-led intervention grounded in Orem’s Self-Care Deficit Theory, integrating educational, psychosocial, and behavioral components. Phase II used a quasi-experimental two-group pretest–posttest design (n = 93; intervention = 47, control = 46). The intervention group (IG) received the structured nurse-led intervention in addition to routine care while the control group received routine hemodialysis care alone, including monitoring of vital parameters, body weight, and standard supportive nursing care. The intervention was delivered individually during dialysis sessions over 2 weeks. Outcomes – knowledge, self-care practices, self-efficacy, and Kidney Disease Quality of Life (KDQOL) – were measured at baseline, day 30, and day 45 using validated tools. Results: Six interconnected stressor domains emerged: financial strain, emotional distress, fear and uncertainty, lifestyle disruption, social isolation, and physical limitations. The IG demonstrated significant improvements in knowledge, self-care practices, and self-efficacy (P < 0.001), sustained to day 45. Significant improvements were also observed across several KDQOL domains. Postintervention, self-efficacy showed strong positive correlations with quality-of-life dimensions (r = 0.72–0.92; P < 0.001). Conclusion: A patient-informed, theory-driven nurse-led intervention addressing psychological, social, and behavioral dimensions significantly strengthens self-efficacy and enhances quality-of-life outcomes, supporting its integration into comprehensive hemodialysis nursing care.
Abstract from DOAJ. Public domain (CC0 1.0).
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