Effect of a health-promoting behavior-based educational program on the resilience of hemodialysis patients: A randomized controlled trial

Health-promoting behaviors play a crucial role in maintaining overall well-being and have been widely recognized as a key factor in enhancing resilience. This study aimed to investigate the impact of education on health-promoting behaviors and resilience in patients undergoing hemodialysis. This randomized controlled trial was conducted among hemodialysis patients referred to dialysis centers in Gonbad-e Kavus Province in 2018. A total of 40 patients were selected through convenience sampling and randomly assigned to either an intervention or control group. The intervention group participated in six educational sessions on health-promoting behaviors, delivered over a period of two weeks, consisting of three 30-minute sessions per week. Data were collected using a demographic information questionnaire and the Connor-Davidson Resilience Scale (CD-RISC). The intervention group exhibited higher resilience levels (61.72 [SD=12.62]) compared to the control group, which had a moderate level of resilience (65.51 [SD=8.71]). Repeated-measures analysis revealed a significant difference between the two groups after intervention (P<0.001). The Greenhouse-Geisser test, adjusted for pre-test effects, further confirmed significant differences in resilience scores before, immediately after, and one month post-intervention (P<0.001, Eta=0.636), with 63% of the variation in post-test scores attributed to the intervention. The study findings suggest that educating patients on health-promoting behaviors significantly enhances resilience in individuals undergoing long-term hemodialysis. Given that chronic kidney failure and hemodialysis lead to significant lifestyle changes—including reduced physical efficiency, social isolation, hopelessness, and decreased resilience—nursing care and patient education should be prioritized to improve resilience and overall quality of life in this patient population.