Nurse-Led Dialysis Self-Management Program for Hemodialysis Distress

Hemodialysis patients may experience dialysis-related distress due to long-term treatment requirements, dietary and fluid restrictions, medication use, vascular access problems, dialysis-related symptoms, and psychosocial challenges. Nurse-led self-management programs may help patients improve dialysis self-management, reduce distress, and support treatment adherence. This study aims to evaluate the effect of a nurse-led needs-based dialysis self-management program on dialysis-related distress in patients receiving hemodialysis. The study will be conducted as a single-center, two-arm, parallel-group, randomized controlled trial. A total of 100 adult hemodialysis patients will be randomly assigned to either the intervention group or the control group in a 1:1 ratio. Participants in the intervention group will receive a 6-week nurse-led needs-based dialysis self-management program in addition to routine hemodialysis care. Participants in the control group will continue routine hemodialysis care. Data will be collected at baseline, 6 weeks, and 18 weeks. The primary outcome is dialysis-related distress. Secondary outcomes include illness and treatment uncertainty, treatment adherence, and clinical adherence indicators.

Inclusion Criteria: * Aged 18 years or older * Receiving hemodialysis treatment for at least 3 months * Receiving hemodialysis treatment at least twice per week * Able to read and understand Turkish * Conscious and able to communicate * Providing written informed consent Exclusion Criteria: * Advanced cognitive impairment * Active psychiatric crisis * History of major surgery or acute severe illness within the last 3 months * Planned kidney transplantation in the near future * Serious physical or communication problems that may prevent regular participation in the intervention sessions * Concurrent participation in another structured education or psychosocial intervention program