การพัฒนาโปรแกรมการจัดการภาวะโพแทสเซียมในเลือดสูงสำหรับผู้ป่วยฟอกเลือดด้วยเครื่องไตเทียม

Abstract

ABSTRACT

Objective:This study aimed to develop and evaluate a hyperkalemia management program for hemodialysis patients based on the Health Belief Model (HBM) and participatory action research.

Methods:A two-cycle participatory action research (Plan–Act–Observe–Reflect: PAOR) was conducted at a regional dialysis unit in Thailand. The first phase involved 79 regular hemodialysis patients for baseline data collection. In the second phase, 49 patients who had experienced at least one episode of serum potassium ≥ 6.0 mEq/L within the preceding three months were purposively selected to participate in the intervention. The program included health education sessions, individualized dietary counseling, and the use of educational media. Research instruments comprised a knowledge test, health belief questionnaire, behavior assessment, and serum potassium results. Data were analyzed using descriptive statistics and repeated measures ANOVA.

Results:At baseline, participants had moderate to low levels of knowledge, health beliefs, and potassium-control behaviors. Following the implementation of the two-cycle intervention, significant improvements were observed in knowledge scores, health belief domains (particularly perceived severity and self-efficacy), and dietary behaviors. Additionally, mean serum potassium levels significantly decreased (p < .001).

Conclusion:The hyperkalemia management program developed through action research effectively promoted behavioral change and improved clinical outcomes in hemodialysis patients. It demonstrates strong potential for application in regional dialysis care settings.