The Orem Self-Care Based Protocol on Interdyalitic Weight Gain (IDWG) in Chronic Kidney Disease Hemodialysis Patients in the Hospital
DOI:
https://doi.org/10.37287/ijghr.v8i1.293Keywords:
chronic kidney disease, hemodialysis, IDWG, nursing, self-care oremAbstract
Chronic Kidney Disease (CKD) is a health problem with increasing prevalence in Indonesia and globally. Patients with end-stage CKD generally undergo hemodialysis as replacement therapy, but this is often accompanied by complications such as Interdialytic Weight Gain (IDWG) due to excess fluid between dialysis sessions. Uncontrolled IDWG can lead to hypertension, pulmonary edema, and even heart failure. Therefore, effective nursing interventions are needed to help patients manage IDWG, one of which is through the application of Orem's Self-Care theory. This study aims to analyze the effectiveness of implementing the Orem Self-Care based protocol on IDWG in hemodialysis patients with chronic kidney failure at Dr. Loekmonohadi Hospital, Kudus. The study design used a quasi-experimental approach with a pre-test–post-test control group design . The sample consisted of 84 hemodialysis patients selected using a saturated sampling technique and divided into an intervention group (n=42) and a control group (n=42). Data collection was conducted by measuring the patients' Interdialytic Weight Gain (IDWG) before and after the intervention. The intervention included fluid management education, weight monitoring, and fluid restriction strategies. Data analysis was performed using a paired t-test and a test for differences between groups with a significance level of p < 0.05. Before the intervention, the majority of patients were unable to control their IDWG (88.1 % in the intervention group; 81.0% in the control group). After the intervention, 90.5 % of the intervention group achieved IDWG control compared to only 26.2% in the control group. The mean IDWG decreased from 4.99 kg to 3.14 kg, with a significant difference of 1.85 kg (p < 0.001). The Orem Self-Care based protocol is effective in reducing IDWG in hemodialysis patients with CKD, increasing patient independence, and potentially preventing complications due to fluid overload.
References
Alikari, V., Tsironi, M., Matziou, V., Tzavella, F., Stathoulis, J., Babatsikou, F., Fradelos, E., & Zyga, S. (2018). The impact of education on knowledge, adherence, and quality of life among patients on hemodialysis. Quality of Life Research, 27 (9), 2457-2465. https://doi.org/10.1007/s11136-018-1989-y
Dahlan, MS (2014). Statistics for medicine and health . Salemba Medika.
Hermalia, H., & Silvitasari, I. (2020). The effect of self-management dietary counseling on the quality of life of hemodialysis patients. 'Aisyiyah Nursing Journal , 7(1), 39–47.
Kementerian Kesehatan RI. (2018). Laporan Hasil Riset Kesehatan Dasar (Riskesdas) 2018.
Lestari, I., Widyastuti, R., & Sari, R. (2018). The relationship between interdialytic weight gain and quality of life in hemodialysis patients. Journal of Nursing , 10(2), 112–118.
Mardiyah, A., & Zulkifli, S. (2023). Selfcare in relation to dietary compliance for nutrition and fluid among patients undergoing hemodialysis. Nursing Pearl Journal, 6 (2), 158-171. https://doi.org/10.51544/jmn.v6i2.3940
Orem, D. E. (2001). Nursing: Concepts of practice (6th ed .). Mosby.
Ossareh, S., Roozbeh, J., Krishnan, M., Bargman, J. M., & Oreopoulos, D. G. (2014). Education based on self-care theory improves adherence to fluid restriction in hemodialysis patients. Nephrology Dialysis Transplantation, 29 (1), 201–207.
Indonesian Nephrology Association (PERNEFRI). (2018). Indonesian Renal Registry 2018 .
Sajjadi, S.L., Ghafourifard, M., & Tayebi Khosroshahi, H. (2025). A randomized controlled clinical trial of individualized patient education on hemodialysis adequacy and interdialytic weight gain. Journal of Caring Sciences, 14 (1), 5-13. https://doi.org/10.34172/jcs.025.33604
Smeltzer, S. C., & Bare, B. G. (2015). Brunner & Suddarth's textbook of medical-surgical nursing (13th ed .). Lippincott Williams & Wilkins
Sulistyaningsih, DR, Nurachmah, E., Yetti, K., & Hastono, SP (2020). The experience of adherence among hemodialysis patients undergoing therapeutic regimen: A qualitative study. F1000Research, 9 , 1485. https://doi.org/10.12688/f1000research.27729.1
Sugiyono. (2019). Metode penelitian kuantitatif, kualitatif, dan R&D. Alfabeta.
Wasalamah, B., Alim, S., & Widyandana, D. (2022). Supportive educational nursing intervention (SENI) as intervention in enhancing self-efficacy among hemodialysis patients. Journal of Health Sciences and Medical Development, 1 (1), 1-11. https://doi.org/10.56741/hesmed.v1i01.30
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
