Nutritional indicators and fluid self-efficacy among hemodialysis patients in the Qassim region, Saudi Arabia: a multicenter descriptive cross-sectional study

Background Hemodialysis is a life-sustaining renal replacement therapy that removes metabolic waste products normally eliminated by the kidneys. Patients undergoing hemodialysis are required to adhere to strict fluid and dietary restrictions to prevent serious complications. Fluid self-efficacy is a key determinant of adherence, as it enhances motivation, supports emotional regulation, and promotes engagement in health-related behaviors. Aim To investigate nutritional indicators and fluid self-efficacy among hemodialysis patients in Qassim Region, Saudi Arabia. Methods A descriptive cross-sectional study was conducted within 4 months using a convenience sample of 200 adult hemodialysis patients recruited from five dialysis centers across three major cities in Qassim region, Saudi Arabia, namely Buraydah, Unaizah, and Al-Rass. Data collection tools were adapted and consisted of four main parts: socio-demographic characteristics, hemodialysis history, nutritional parameters, and fluid self-efficacy, in addition to anthropometric measurements. Data were analyzed using SPSS version 20.0. Results A total of 59.5% of participants demonstrated low fluid self-efficacy, with a Mean ± SD of 17.0 ± 6.57 and an average item score of 1.70 ± 0.66. A statistically significant relationship was found between nutritional indicators and duration of hemodialysis, specifically regarding weight change over the last 6 months ( p = 0.035). Additionally, gender showed a significant association with fluid self-efficacy ( p = 0.003). Conclusion Hemodialysis patients exhibited generally low levels of fluid self-efficacy, with weight changes over 6 months and gender identified as significant associated factors. These findings provide preliminary evidence that behavioral, nutritional, and psychosocial factors may be associated with self-efficacy and adherence. The results highlight the potential importance of integrating targeted patient education, structured behavioral interventions, and continuous nursing support to enhance self-efficacy and promote adherence to fluid. Tailored, nurse-led strategies incorporating individualized counselling and supportive monitoring to improve patient outcomes.