INTRODUCTION:

End stage renal disease (ESRD) is a chronic and life-threatening illness. In which kidneys are permanently damaged and the person can no longer survive independently without renal replacement therapy. Renal replacement therapy involves either dialysis or a kidney transplant. Peritoneal dialysis (PD) and hemodialysis (HD) are the two main forms of dialysis. In India, hemodialysis is the preferred option used by most centers. HD is a treatment that cleanses blood of the wastes and excess fluid that have built up. During hemodialysis, blood travels through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer, or an artificial kidney^[1].

It is estimated that presently, more than 2.5 lakh people develop kidney failure and 1 lakh new patients of ESRD enter renal replacement therapy annually in India. A very conservative estimate of the ESRD burden, based on a population of 1.1 billion, is that 1,650,000 to 2,200,000 people develop ESRD in India annually, of whom only 10% or less receives treatment. The rest die every year, which means that approximately 150,000 to 200,000 people die of ESRD in India annually. The prevalence of CKD and the need of dialysis in India is expected to reach 2 crores and 20 lakhs respectively by 2025^[4].

OBJECTIVES:

1. To assess the level of knowledge on dietary management among chronic renal failure patients.

2. To associate the knowledge on dietary management with their demographic variables.

HYPOTHESIS:

H₁: There will be a significant association between knowledge regarding dietary management and their demographic variables.

METHODOLOGY:

Research approach:

Quantitative evaluative research approach was adopted for this study

Research design:

The research design chosen for this study was descriptive cross-sectional research design

Population:

Population refers to the dialysis patients undergoing hemodialysis treatment in outpatient department of selected hospital, Kanchipuram.

Sampling:

Sample:

Patients who were fulfilling the sampling criteria are included for the study.

Sample size:

The sample size was comprised of 30patients.

Sampling technique:

The technique adopted for this study was Non-probability convenient sampling technique^[2].

Criteria for sample selection:

Inclusion Criteria:

· Patients of both sexes

· Patients above the age of 25 years

· Those who are available during data collection period

· Those who able to understand Tamil

· Patients who are willing to participates

Exclusion Criteria:

· Patients undergone major kidney surgery

· Patients having any mental illness

Variables:

Research variable: level of knowledge regarding dietary management of chronic renal failure

Demographic variable: age, gender, marital status, type of family, religion, education, occupation, monthly income, duration time, treatment of dialysis.

Data collection procedure:

The data was collected between 20.04.11 to 25.04.11. The investigator uses interview schedule in Tamil (language) was used to assess the knowledge and practices of dialysis patients regarding self-care. The patient was interviewed during hemodialysis. Patients were made to feel comfortable and relax. Interview was planned to conduct 6-8 patients per day. The items were asked as per interview schedule. Responses were recorded as per interview schedule during interview. The investigator conducted the test to assess the knowledge on dietary management among chronic renal failure patients undergoing hemodialysis with help of structure questionnaire.

Method of data collection:

Tool used for the study:

Structured questionnaire method.

Description of the tool:

It consists of section-I and section-II

Section I

It consists of demographic variables of people such as age, gender, marital status, type of family, religion, education, occupation, monthly income, duration of dialysis, treatment of dialysis.

Section II

The data was collected through the well prepared multiple choice questionnaire. It consists of 15 questions and total score was 15. Each correct response was given a score of one and the wrong answer will be given the score of zero. It assesses the knowledge on dietary management among chronic renal failure patients undergoing hemodialysis at selected hospital.

Validity:

The tool was prepared by the investigator based on literature review, under the guidance of experts and on the basis of objectives, which had been assessed and evaluated, accepted by experts of research committee. The content validity of the tool was obtained from research experts from the medical surgical nursing.

Data analysis and interpretation:

Part-1

Table: 1 Frequency and percentage distribution of the hemodialysis patients according to their demographic variables N=30

S. No	Demographic variables	Frequency (f)	Percentage (%)
1	Age
	a) 25 – 35	11	36.66
	b) 36 – 45	7	23.33
	c) 46 – 55	6	20
	d) 56 – 65	6	20
2	Gender
	a) Male	24	80
	b) Female	6	20
3	Marital status
	a) Single	6	20
	b) Married	24	80
	c) Divorced	-	-
	d) Widow	-	-
4	Type of family
	a) Nuclear	25	83.33
	b) Joint	5	16.66
5	Religion
	a) Hindu	15	50
	b) Christian	11	36.66
	c) Muslim	4	13.33
	d) Other	-	-
6	Education
	a) Primary	8	26.66
	b) Secondary	7	23.33
	c) Graduate	12	40
	d) Post graduate	3	10
7	Occupation
	a) Govt. employee	8	26.66
	b) Private employee	8	26.66
	c) Business	2	6.66
	d) Agriculture	7	23.33
	e) Others	5	16.66
8	Monthly income
	a) £ 5000	12	40
	b) 5001 – 10000	13	43.33
	c) 10001 – 15000	5	16.66
	d) > 15000	-	-
9	Duration time
	a) < 1 year	3	10
	b) 1-3 years	14	46.66
	c) 3-5 years	10	33.33
	d) > 5 years	3	10
10	Treatment of dialysis
	a) Once a week	12	40
	b) Twice a week	18	60
	c) Thrice a week	-	-

Table -1 shows that the distribution of their demographic variables. Majority of patients 11(36.66%) were in the age group of 25-35 years, majority of sample 24(80%) were male, majority of sample 24(80%) had married, majority of them 25(83.33%) belongs to nuclear family, half of them 15(50%) belongs to Hindu, 12(40%) of them had graduate, equal of them sample 8(26.66%) were working Govt. employee and private employee, 13(43.33%) had monthly income of 5001-10000. Nearly half of them 14(46.66%) were undergone 1-3 years, and most of them 18(60%) getting treatment twice a week.

Table-2: Frequency, percentage, mean and standard deviation of hemodialysis patients according to their level of knowledge n=30

Level of knowledge	Frequency	Percentage	Mean	SD
Inadequate	4	13.33	9.27	1.913
Moderately adequate	20	66.66
Highly adequate	6	20

Table-2 shows that most of sample 20(66.66%) had moderately adequate knowledge, 6(20%) had highly adequate knowledge and 4(13.33%) had inadequate knowledge. The mean score was 9.27±1.913.

.Part-II level of knowledge according to the grade score of chronic renal failure patients undergoing hemodialysis.

Figure: 1 shows that 13.33% of them had inadequate knowledge, 66.66% had moderately adequate knowledge and 20% had highly adequate knowledge regarding dietary management for chronic renal failure.

Part III

Table-3: Association between the Level of Knowledge of dietary management among hemodialysis patients and their Selected Demographic Variables n=30

S. No	Variable	Df	c²	Table value
1	Age	6	15.74*	12
2	Gender	2	10.07*	5.99
3	Marital status	6	4.33	12
4	Type of family	3	12*	7.01
5	Religion	6	16.82*	12
6	Education	6	23.44*	12
7	Occupation	8	9.08	15.5
8	Monthly income	6	3.48	12
9	Duration time	6	11.17	12
10	Treatment of dialysis	4	1.9	9.39

* significant at p<0.05 level

Table-3 shows that there is significant association between level of knowledge regarding dietary management among chronic renal failure patient undergoing hemodialysis with their selected demographic variable such as age, gender, type of family, religion, education and there was no significant association other variable like marital status, occupation, monthly income, duration of time, and treatment of dialysis.

DISCUSSION:

The study was done to assess the level of knowledge on dietary pattern among chronic renal failure patients undergoing hemodialysis at selected hospital, kanchipuram. Out of 30 patients 20(66.66%) had moderately adequate knowledge, 6(20%) had highly adequate knowledge and 4(13.33%) had inadequate knowledge.

RECOMMENDATION:

Based on the research findings the following recommendations can be made:

1. The same study can be replicated on a larger sample and also at different settings.

2. A structured teaching programme on dietary management of chronic renal failure patients can be prepared and given to the hemodialysis patients for impacting the knowledge.

3. A comparative study should be done on dietary management of chronic renal failure patients between urban and rural peoples.

CONCLUSION:

A descriptive survey was conducted to assess the level of knowledge on dietary management among chronic renal failure patient undergoing hemodialysis at selected hospitals, Kanchipuram. Interview method was adopted for this study. Majority of the patients on hemodialysis having the moderate and adequate knowledge about dietary management.

BIBLIOGRAPHY:

1. Brunner and Suddarth’s, Textbook of Medical Surgical Nursing Wolters Kluwer, Lippincott Williams and Wilkins Publications, 2010, 12^th ed.

2. Polit and Beck Nursing Research Generating And Assessing Evidence For Nursing Practice Wolters Kluwer, Lippincott Williams and Wilkins Publications,2012,9^th ed.

3. BT Basvanthappa Nursing research, Jaypee Brothers Medical Publishers(P)Ltd, New Delhi,2007,2^nd ed

4. Bickerton, T, Textbook Medical Surgical Nursing, William Heinemann Medical books Ltd,1985,1^sted

Received on 20.07.2014 Modified on 12.08.2014

Int. J. Nur. Edu. and Research 2(3): July- Sept. 2014; Page 241-244