Document Type : Original Article

Authors

1 Social Determinants of Health Research Center, Shahrekord University of Medical Sciences

2 Department of Health Education and Health Promotion, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

INTRODUCTION: Health promotion through lifestyle improvement is an important topic that has
received considerable attention from the scientific community worldwide. This study aimed to
determine the effect of Pender’s health promotion model on self-efficacy and treatment adherence
behaviors of hemodialysis patients in Shahrekord, Iran, in 2018–2019.
METHODS: This quasi-experimental study was performed on 70 hemodialysis patients who were
attending routine hemodialysis sessions in Hajar hospital in Shahrekord. Individuals were selected
by simple random sampling and randomly assigned to two groups of control and intervention.
In the preintervention stage, all patients completed a questionnaire that was prepared to collect
demographic information and measure health-promoting behaviors, self-efficacy, and treatment
adherence. The intervention group participated in eight sessions of a health promotion model-based
education program. Both groups were asked to complete the questionnaire again immediately after
the intervention and also 2 months later.
RESULTS: The repeated measures analysis of variance (ANOVA) showed a significant difference
between the two groups in terms of the extent of change in mean scores over the three measurement
stages (before the intervention, after the intervention, and 2 months after the intervention) (P < 0.001).
A statistically significant difference was observed between the two groups in terms of self-efficacy
scores in the postintervention and follow-up stages (P < 0.05). The repeated measures ANOVA also
revealed a significant difference between the two groups in terms of the extent of change in mean
treatment adherence scores over the three measurement stages (P < 0.001).
CONCLUSION: Considering the positive effects of the program on patients undergoing hemodialysis,
it is recommended to use the program to promote the well-being of these patients without time
restrictions.

Keywords

1. Brunner LS. Brunner & Suddarth’s Textbook of Medical-Surgical
Nursing. Philadelphia, LWW Publishing: Lippincott Williams &
Wilkin; 2010.
2. Denhaerynck K, Manhaeve D, Dobbels F, Garzoni D, Nolte C,
De Geest S. Prevalence and consequences of nonadherence to
hemodialysis regimens. Am J Crit Care 2007;16:222-35.
3. Cinar S, Barlas GU, Alpar SE. Stressors and coping strategies in
hemodialysis patients. Pak J Med Sci 2009;25:447-52.
4. Heidarzadeh M, Atashpeikar S, Jalilazar T. Relationship
between quality of life and self-care ability in patients receiving
hemodialysis. Iran J Nurs Midwifery Res 2010;15:71-6.
5. Kazemi M, Nasrabadi AN, Hasanpour M, Hassankhani H,
Mills J. Experience of Iranian persons receiving hemodialysis:
A descriptive, exploratory study. Nurs Health Sci 2011;13:88-93.
6. Mahdavi-Mazdeh M, Zamyadi M, Nafar M. Assessment
of management and treatment responses in haemodialysis
patients from Tehran province, Iran. Nephrol Dial Transplant
2008;23:288-93.
7. Nadeem M. Compliance of end stage renal disease patients on
haemodialysis. J Rawal Med Coll 2011;15:30-2.
8. Loghman-Adham M. Medication noncompliance in patients with
chronic disease: Issues in dialysis and renal transplantation. Am
J Manag Care 2003;9:155-71.
9. Schmid H, Hartmann B, Schiffl H. Adherence to prescribed oral
medication in adult patients undergoing chronic hemodialysis:
A critical review of the literature. Eur J Med Res 2009;14:185-90.
10. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG,
Chertow GM. Mineral metabolism, mortality, and morbidity in
maintenance hemodialysis. J Am Soc Nephrol 2004;15:2208-18.
11. Nabolsi MM, Wardam L, Al-Halabi JO. Quality of life, depression,
adherence to treatment and illness perception of patients on
haemodialysis. Int J Nurs Pract 2015;21:1.
12. Masoud Rayyani LM, Forouzi MA, Razban F. Self-care selfefficacy and quality of life among patients receiving hemodialysis
in South-East of Iran. Asian J Nur Edu Res 2014;4:165-71.
13. Lloyd J, Bond FW, Flaxman PE. Work-related self-efficacy as a
moderator of the impact of a worksite stress management training
intervention: Intrinsic work motivation as a higher order condition
of effect. J Occup Health Psychol 2017;22:115-27.
14. Han TY, Cotter KA. Work-related stress factors and health
management among Korean workers with diabetes. J Manag
Psychol 2015;30:470-86.
15. Toker S, Gavish I, Biron M. Job Demand–Control–Support and
diabetes risk: The moderating role of self-efficacy. Eur J Work
Organ Psychol 2013;22:711-24.
16. Meyer MR, Patterson MS, Daughtery MF, von Ahn K, Bowden RG,
Beaujean AA, et al. Is Physical Activity Self-efficacy for Patients
With End-stage Renal Disease Meaningful? An Inpatient Pilot
Study. J Acute Care Phys Ther 2016;7:65-75.
17. Radmehr M, Ashktorab T, Neisi L. Effect of the educational
program based on Pender’s theory on the health promotion
in patients with obsessive-compulsive disorder. J Nurs Educ
2013;2:56-63.
18. Narayan KM, Gregg EW, Fagot-Campagna A, Engelgau MM,
Vinicor F. Diabetes – A common, growing, serious, costly, and
potentially preventable public health problem. Diabetes Res Clin
Pract 2000;50 Suppl 2:S77-84.
19. Fenton JJ, Von Korff M, Lin EH, Ciechanowski P, Young BA.
Quality of preventive care for diabetes: Effects of visit frequency
and competing demands. Ann Fam Med 2006;4:32-9.
20. Akbar W, Mohamad A. Self management in diabetes refer to Yazd
diabet research center. J Yazd Med Sci Univ 2003;11:33-7.
21. Dehdari T, Rahimi T, Aryaeian N, Gohari MR. Effect of nutrition
education intervention based on Pender’s Health Promotion
Model in improving the frequency and nutrient intake of breakfast
consumption among female Iranian students. Public Health Nutr
2014;17:657-66.
22. Hosseini M, Yaghmaei F, Hosseinzade S, Alavi Majd H,
Sarbakhsh P, Tavousi M. Psychometric evaluation of the “Health
Promoting Life Style Profile 2”. Health Monitor Journal of the
Iranian Institute for Health Sciences Research. 2012;11(6):849-56.
23. Safabakhsh L, Arbabisarjou A, Jahantigh M, Nazemzadeh M,
Rigi SN, Nosratzehi S. The effect of health promoting programs on
patient’s life style after coronary artery bypass graft–hospitalized
in Shiraz hospitals. Glob J Health Sci 2016;8:154.
24. Kim KK. Relationship between Illness Perceptions, Treatment
Adherence and Clinical Outcomes in Maintenance Hemodialysis
Patients. Los Angeles: University of California; 2009.
25. Chehri M, Farsi Z, Zareiyan A. The Effect of a Healthcare Plan
Based on the Pender Health Promotion Model on Quality of Life
in Patients with Heart Failure in a Military Setting Military Caring
Sciences. Spring 2018;5:13- 25.
26. Yavuz AY, Hacıalioğlu N. The effect of training provided for
obese adolescents based on Health Promotion Model on their
healthy lifestyle behaviors and life quality. Progress in Nutrition
2018;20:146-60.
27. Balaga PA. Self-efficacy and self-care management outcome of
chronic renal failure patients. Asian J Health 2012;2:111-29.
28. Mohseni PH, Majlessi F, Shojaeizadeh D, Rahimi FA. The effect of
educational intervention based on the Pender’s health promotion
model on patients’self-efficacy for self-care behaviors following
heart surgery. Iranian Journal of Nursing Research 2017;12:16-23.