The effect of education based on the roy adaptation model on the stress, psychosocial adjustment and self-care ability of the hemodialysis patients

The study was conducted as a randomized controlled trial to evaluate the effect of the education based on Roy Adaptation Model on the outpatient dialysis patients in terms of the stress, psychosocial adjustment and self-care ability. Sample population consists of 80 dialysis patients from Gaziantep University Sahinbey Research and Practice Hospital Hemodialysis Department, treated between 01 September and 30 November 2016. The sample of the study consisted of 40 experimental and 40 control patients, who were the whole population. The control group was trained by the nurses in the hemodialysis clinic while the experimental group was trained according to the Roy Adaptation Model. For the pre-test data, the introductory information was collected from the experimental and control group by applying self-care ability assessment scale, hemodialysis stress scale, and psychosocial adjustment self-report scale for chronic dialysis patients. After the preliminary tests, the training requirements of the patients in the experimental group were determined and training was carried out twice in a month, and 6 times in total, at home or in the clinic. At the end of each month, the same data collection instruments were applied to the experimental group and interim data were collected. Two weeks after the interim tests, the measurements were repeated to obtain the final test data, and at the end of the study the training booklet was given to the patients. Interim tests were not applied to the control group, while the final test data were collected together with the experimental group's final test data without any intervention, and then the same training booklet was given. In pre-test comparisons of experimental and control groups; in the experimental group the average hygienic care, which is the sub-dimensions of the self-care ability evaluation (5.0±1.0), and in the control group, the health care orientation, which is the sub-dimentions of the psychosocial adjustment to disease (7.8± 4.5), professional environment (10.8± 3.3), familial environment (9.8± 5.3), sexual intercourse (10.7± 4.1), extended family relationships (4.9± 3.5), social environment (7.8± 4.6), and total scale score (60.7± 21.1), were found significantly higher than experimental group (p < 0.05). In the repeated measures of the experimental group, all the sub-dimensions except the self-monitoring which is the sub scale of self-care ability, were significantly improved (p<0.05). In the final test comparisons of the experimental and control groups, in the experimental group, all the sub-dimensions except the mental state sub-scale from the self-care ability evaluation scale were significantly changed as expected. These findings suggest that; the education given to hemodialysis patients according to the Roy Adaptation Model has been effective in reducing the stress level of patients, and increasing psychosocial adjustment and self-care ability. It is suggested that nurses working with hemodialysis patients should train them based on the Roy Adaptation Model and apply above-mentioned scales to evaluate the educational effectiveness. Keywords: Hemodialysis, Roy Adaptation Model, Stress, Self Care Ability, Psychosocial Adjustment, Nursing.