The effect of a care plan based on the roy adaptation model on general health in hemodialysis patients; A randomized controlled clinical trial

Abstract

Introduction: Evidence suggests that end-stage renal disease (ESRD) significantly affects general health in the patients, causing their general health to be poorer compared to the general population. The Roy adaptation model (RAM) is the best one for ESRD patients. Objectives: The present study aimed to determine the effect of a RAM-based care plan on general health in hemodialysis patients. Patients and Methods: This randomized controlled clinical trial conducted on 60 hemodialysis patients in Iran. The data collected using a demographic questionnaire and the general health questionnaire-28 (GHQ-28). In the intervention group, the Roy assessment form was completed and the RAM-based care plan was then trained in four group sessions over 4 weeks. Individual sessions were also held if required and patients followed-up for 2 weeks. The control group received only routine care. At the end of the follow-up, general health was re-assessed in the patients. The findings were analysed using t test, the chi-square test and the McNemar test. Results: Despite observing no significant differences between the two groups in terms of general health levels before the intervention (P = 0.530), the difference was significant after the intervention (P = 0.028), since the mean score of general health decreased by 4.07 in the intervention group compared to before the intervention (P = 0.003). The intervention significantly affected the subscales of somatic symptoms (P = 0.013), anxiety and insomnia (P = 0.006), social dysfunction (P = 0.016) and depression (P = 0.031). Conclusion: The findings suggested the positive effects of using the RAM on general health in hemodialysis patients. The RAM is therefore recommended that be used as a holistic care approach to improving general health in these patients. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT201411198665N4; https://irct.ir/trial/9154).