Lim Z.1, Ling A.1, Lim C.H.1, Yee C.F.1, Choo L.2, Kaur D.3, Low A.3, Khan B.A.4
1 Dietetics Department, The National Kidney Foundation Singapore
2 Occupational Therapy Department, The National Kidney Foundation Singapore
3 Exercise & Fitness Department, The National Kidney Foundation Singapore
4 Medical Services Department, The National Kidney Foundation Singapore
Optimal nutrition management and active lifestyle play a vital role in improving the quality of life in haemodialysis (HD) patients. This study describes Rehabilitation, Nutrition and Active Lifestyle (ReNAL) program development by multidisciplinary (MDT) team comprising of dietitians, exercise specialists and occupational therapist in empowering patients on self-management.
A 6-month ReNAL program was designed with monthly nutrition themes, enhanced with relevant exercise and rehabilitation components to improve lifestyle (e.g. Introduction to ReNAL; Protein and muscle strengthening exercise; Phosphate and intradialytic exercise; Potassium and kitchen safety practices; Fluid management in community; Summary of HD diet). Language grouping and various educational tools (e.g. video, photocards, interactive games) were used in this 1-hour group education to enhance learning experience. Interested participants and patients with biochemical derangement were recruited from 7 satellite HD centres in Singapore. The outcome measures were (a) improvement of nutrition knowledge collected at baseline and 1 month following the session; (b) awareness and attitude towards nutrition and lifestyle management assessed immediately after the session. Descriptive statistics were used to describe demographic and knowledge improvement.
Results & Discussion
A total of 54 patients and 12 caregivers attended ReNAL. Majority of patients were male (57.4%), Chinese (64.8%) with mean age 63.6¬±1.4years. More than 90% of participants expressed interest to increase physical activity and showed knowledge improvement in renal rehabilitation. 53-79% of participants improved in their nutrition knowledge with greatest improvement observed in Potassium related knowledge.
The preliminary findings suggested that ReNAL program was able to instil positive awareness and improve nutrition knowledge among HD patients for most sessions, which in turn may improve patient's ability for self-care and eventually quality of life. Future study focusing on clinical outcomes and behavioural changes should be considered to evaluate its effectiveness.