Lim Z.1, Ling A.1, Lim C.H.1, Yee C.F. 1, Khan A.B.2
1Dietetics Department, The National Kidney Foundation Singapore
2Medical Services Department, The National Kidney Foundation Singapore
A patient-centered group nutrition education (PC-GNE) approach may promote positive learning behaviour apart from being more cost- and time- effective as compared to individualized counselling. This study assesses the impact of PC-GNE on knowledge and behavioural changes among haemodialysis patients.
This study recruited haemodialysis patients with suboptimal protein-related biochemical markers (nPCR <1.0 or Albumin <35g/dL) or interested in PC-GNE from seven dialysis centres. Protein-themed PC-GNE were conducted in multi-languages with dietitian to participants ratio of 1:6. Each session was 1 hour, conducted using interactive games and discussions with food photos, real food items and video. Pre-quiz was administered to understand patients’ knowledge gap for pre-adjustment of training plan. Post-quiz was conducted one month later to assess knowledge retention. Changes in patient’s knowledge scores were analysed using paired-T test, with P-value <0.05 as statistically significant.
Results & Discussion
30 patients (53% male, 57% Chinese, mean age 63±2 years, mean dialysis vintage 5±1 years and mean BMI 24.4±0.6kg/m2) were included in the study. Patient’s knowledge regarding Protein significantly improved after the session with mean scores increased from 6.2±0.3 to 7.3±0.2 (p<0.05), for a full score of 9. Protein requirement was focused and taught using interactive game following poor score during pre-quiz, and showed greatest improvement, with an increase from 10% to 60% of patients answered correctly after PC-GNE. The least improved question was regarding one protein portion taught by showcasing real food items, where 57% patients still answered incorrectly post-session. It is observed that experiential learning improved patient’s knowledge more effectively. Among 16 patients who completed behavioural survey, 12 reported on relevant dietary changes, while 4 reported no changes made.
This study showed that well-curated PC-GNE with experiential learning improved patient’s nutritional knowledge and promoted dietary changes. Further studies on PC-GNE’s effectiveness in promoting behavioural changes and clinical outcomes are warranted.