Supporting Caregivers of Hemodialysis Patients: Applying the 5-A Self-management Model to Alleviate Caregiver Burden

Abstract
Background: Enduring chronic renal failure and undergoing hemodialysis significantly impact patients' and their caregivers' physical, spiritual, psychological, and functional abilities. Objectives: To examine the impact of implementing the 5-A self-management model on the burden experienced by caregivers of patients undergoing hemodialysis. Methods: This experimental study, utilizing a pre-test and post-test design, involved 90 caregivers of patients undergoing hemodialysis. Caregivers were selected through simple random sampling. Data were collected using a demographic questionnaire and the ZARIT caregiving burden tool. The intervention included implementing the 5-A Self-Management model. Data analysis involved repeated measures ANOVA, comparing scores before the intervention, immediately after, as well as one and three months later. Results: Prior to the intervention, caregivers in the intervention group experienced higher levels of pressure compared to the control group (P = 0.018). However, one month (P = 0.004) and three months (P = 0.003) after the intervention, the intervention group's scores were significantly lower than those of the control group. Furthermore, the effect of time (P < 0.001) and the interaction effect (P < 0.001) were statistically significant, indicating the intervention's positive impact on caregivers' burden and the differences in score changes over time. Conclusions: Implementation of the 5-A self-management model led to a significant reduction in the burden of caregiving among caregivers of patients undergoing hemodialysis. Providing self-management training tailored to the needs of hemodialysis patients and their caregivers is an effective approach to enhancing caregivers' abilities.
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