The Effect of a Training Intervention Based on Pender’s Health Promotion Model on the Lifestyle of Patients Undergoing Hemodialysis

Abstract

Background: Chronic renal failure and hemodialysis treatment not only affect the physical health of patients, but also jeopardize other aspects of their health, including psychological and social aspects, and reduce their quality of life. Objectives: Accordingly, the present study aimed to investigate the effect of a training intervention developed based on Pender’s health promotion model on the lifestyle of patients undergoing hemodialysis. Methods: Adopting a pre-test and post-test design with a control group, this quasi-experimental study was conducted in 2022 on 60 hemodialysis patients visiting Ali Ibn Abi Talib and Khatam al-Anbiya hospitals in Zahedan, Iran. The patients were selected using convenience sampling and randomly assigned to two intervention and control groups (30 persons in each group). The participants in the intervention group received training based on Pender's health promotion model in six areas (nutrition, physical activity, health responsibility, interpersonal relationships, stress management, and self-actualization) during six 45-minute training sessions. Data were collected using Walker’s (1987) health-promoting lifestyle profile (HPLP-II) which was completed in three stages (before the intervention, one month, and three months after the intervention). Data were analyzed using the independent samples t-test, chi-square test, and repeated-measures analysis of variance (ANOVA) at a significant level (P < 0.05). Results: The data analysis revealed that the mean total lifestyle scores before the intervention were not significantly different in the two groups (P = 0.47). However, the mean total lifestyle score of patients in the intervention group increased compared to the control group one month and three months after the intervention, repeated measures ANOVA did not show a significant interaction effect of time and group (P = 0.06). Similarly, the results of repeated measures ANOVA did not show any significant difference in terms of health responsibility (P = 0.61), stress management (P = 0.94) and relationships/social support (P = 0.22). Given the significant interaction effect of time and group in the repeated measures ANOVA in the dimensions of nutrition (P < 0.001), physical activity (P < 0.001), and self-actualization (P < 0.03), point-by-point comparisons were performed again by time and group with Bonferroni correction. The results showed that the mean score of nutrition significantly improved one and three months after the intervention compared to the pre-intervention phase (P < 0.001). Conclusions: The findings implied that the training intervention based on Pender’s health promotion model clinically improved the lifestyle of patients undergoing hemodialysis. However, sustaining continuous and lasting changes requires supportive programs and long-term monitoring. Further studies with larger sample sizes are recommended to evaluate the effects of the intervention using the Pender approach.