Effect of e-mail education on stress and compliance in Korean elderly on hemodialysis

SummaryBackground/PurposeThe number of elderly patients receiving hemodialysis for end-stage renal disease has increased such that patients aged over 60 years account for 41.4% of the hemodialysis population in Korea. Elderly hemodialysis patients feel more stressed from a social and psychological perspective than from a physical perspective. Thus, it is necessary to develop nursing interventions to decrease the level of stress in Korean elderly hemodialysis patients. The purpose of the present study was to determine the effects of e-mail education about the treatment regimen on stress and compliance in elderly hemodialysis patients.MethodsA non-equivalent pretest–posttest control experimental design was used. Forty patients were allocated to the control (n = 21) and e-mail (n = 19) groups from two hospitals. The e-mail group received an education program about the hemodialysis diet and drug administration by e-mail twice a week for 6 weeks while the control group did not.ResultsStress score (50.22 ± 8.79 vs. 45.13 ± 6.24, p = 0.043), serum cortisol (13.32 ± 3.84 vs. 10.03 ± 3.79 μg/dL, p = 0.031) and epinephrine (28.42 ± 14.50 vs. 20.36 ± 18.07 ng/dL, p = 0.019) of the e-mail group were significantly lower than in the control group. Compliance, including interdialytic weight gain (2.84 ± 0.94 vs. 2.17 ± 0.82 kg, p = 0.038), of the e-mail group was significantly improved compared to the control group.ConclusionThe e-mail education program for Korean elderly hemodialysis patients was effective in improving stress and compliance related to fluid restriction.背景在韓國，因末期腎病正在接受血液透析的病人之間，60 歲以上的病人數目呈現增長，並佔整體血液透析人口的 41.4%。對於年老的病人，血液透析在社會及心理層面上所構成的壓力比身體上的壓力更甚，這種需求必須被納入護理照護的考量中。本研究對年老血液透析患者，透過電郵方式，進行了療程相關的衛教，並調查了此措施對患者壓力及依從性的影響。方法研究採用不相等前測–後測對照組設計，對象來自兩所醫院共 40 位病人，包括對照組 21 人及電郵組 19 人，僅後者以電郵方式接受衛教，內容涵蓋血液透析的飲食與服藥方面，頻率為每週兩次達 6 週。結果相比於對照組，各項指標均以電郵組表現較佳，包括壓力評分 (50.22 ± 8.79 vs. 45.13 ± 6.24、p = 0.043)、血清皮質醇 (13.32 ± 3.84 vs. 10.03 ± 3.79 μg/dL、p = 0.031) 及腎上腺素水平 (28.42 ± 14.50 vs. 20.36 ± 18.07 ng/dL、p = 0.019)；此外，電郵組的依從性亦呈現明顯改善，包括較小的透析間體重增幅 (2.84 ± 0.94 vs. 2.17 ± 0.82 kg、p = 0.038)。結論對於韓國的年老血液透析患者，電郵衛教有效改善了患者的壓力水平及液體限制依從性。