The Results of the Health Literacy Development Program and Self-Care Behavior of Patients with End-Stage Chronic Kidney Disease Receiving Renal Replacement Therapy at Langsuan Hospital, Chumphon

Abstract

        Background: Thailand has seen a continuous increase in patients with end-stage renal disease (ESRD), with an annual growth rate of 15–20%. These patients require renal replacement therapy, which carries inherent risks of complications during hemodialysis. The effectiveness of treatment depends not only on medical equipment but also significantly relies on health literacy.

        Objective: To develop and examine the effects of a health literacy development program on the self-care behaviors of patients with end-stage chronic kidney disease receiving hemodialysis at Langsuan Hospital, Chumphon.

        Methods: This study was a collaborative action research project divided into four phases. Phase 1: Situation Analysis involved examining patient statistics from 2022 to 2024 and conducting in-depth interviews with registered nurses. Phase 2: Program Development focused on creating educational media, which included an information brochure and a 5-minute video, both validated by experts. Phase 3: Implementation was conducted with a sample of 32 patients at Lang Suan Hospital from August 1 to October 31, 2025. Phase 4: Evaluation assessed health literacy and monitored complications. The research instruments consisted of questionnaires and the Langsuan Health Literacy Model (L-HL Model). Data analysis was performed using descriptive statistics and content analysis. 

     Results: The majority of participants were elderly, with a mean age of 66.88 years. After participating in the program, most participants achieved a "relatively good" level of health literacy (68.74%), with an overall mean score of 72.93%. The highest-scoring dimensions were Media Literacy Skills and Decision-Making Skills. The dimension requiring further development was Cognitive Skills (knowledge and understanding), which received the lowest scores. Regarding clinical outcomes, no severe complications (such as acute pulmonary edema or hyperkalemia) were found during hemodialysis after the program implementation.

        Conclusion: The developed health literacy program is effective in promoting self-care behaviors and significantly reduces the risk of complications during hemodialysis.
The participation of healthcare personnel ensured that the media and processes were aligned with the actual context of a community hospital. Given that most participants are elderly, future educational efforts should focus on simple language and clear visual illustrations to further improve foundational knowledge and understanding.