The effect of an education program based on illness perception on self-management among hemodialysis patients: a randomized controlled clinical trial

Self-management is essential for patients undergoing hemodialysis to cope with complex treatment regimens and improve health outcomes. However, many patients experience inadequate self-management. Illness perception, as conceptualized by the Common-Sense Model (CSM), influences health behaviors and may be modified through targeted education. This study evaluated the effect of a CSM-based educational program on self-management among patients undergoing hemodialysis. This randomized controlled trial included 66 patients undergoing hemodialysis at Imam Reza Medical Education Center in Larestan, Iran, from April to August 2024. Participants were randomly assigned to an intervention group ( n = 33), receiving a five-session CSM-based educational program, or a control group ( n = 33), receiving conventional training. Self-management was assessed using the Hemodialysis Self-Management Instrument at baseline and at the end of the eighth week after intervention initiation. Data were analyzed using independent and paired t-tests, the Mann–Whitney U test, and the chi-square test. The groups were comparable at baseline in demographic and clinical characteristics ( P > 0.05). After the intervention, the intervention group showed significant improvements in partnership, problem-solving, self-care, emotional management, and total self-management scores ( P < 0.001). No significant changes were observed in the control group ( P > 0.05). Post-intervention scores were significantly higher in the intervention group for partnership ( P < 0.001), problem-solving ( P = 0.008), self-care ( P < 0.001), emotional management ( P < 0.001), and total self-management ( P < 0.001). A nurse-led, CSM-based educational program effectively improved self-management among patients undergoing hemodialysis. Integrating structured, perception-focused education into routine dialysis care may strengthen nurses’ role in patient empowerment and sustainable self-management. The study was registered with the Iranian Registry of Clinical Trials (IRCT) at https://irct.behdasht.gov.ir (IRCT registration number: IRCT20240122060771N1) on 29 February 2024. The study received ethical approval from the Ethics Committee of Larestan University of Medical Sciences (Ethics code: IR.LARUMS.REC.1402.033).