Front Public Health. 2026 Mar 25;14:1766801. doi: 10.3389/fpubh.2026.1766801. eCollection 2026.
ABSTRACT
OBJECTIVE: This study evaluated the effectiveness of a health education program based on the PRECEDE-PROCEED model in improving self-care, QOL, and biochemical outcomes among HD patients in Indonesia.
METHODS: A quasi-experimental study was conducted involving 90 HD patients allocated to intervention (n = 45) and control (n = 45) groups using a systematic assignment approach. The intervention group received an eight-session PRECEDE-PROCEED-based education program over 4 weeks, while the control group received standard care. Self-care was measured using the Chronic Kidney Disease Self-Management (CKDSM) Questionnaire, QOL was assessed using the SF-36, and biochemical outcomes were evaluated via serum urea and creatinine levels. Data were analyzed using appropriate parametric and non-parametric statistical tests, and effect sizes were calculated using Cohen’s d.
RESULTS: Post-intervention, the intervention group showed significantly greater improvements in self-care (mean difference = 18.33; p < 0.001), QOL (mean difference = 17.25; p < 0.001), and reductions in urea and creatinine levels (p < 0.001 and p = 0.006, respectively), compared to the control group. Large effect sizes were observed for self-care and QOL.
CONCLUSION: The PRECEDE-PROCEED-based educational intervention was associated with improvements in self-care and quality of life, and with favorable short-term changes in selected clinical outcomes among patients undergoing hemodialysis.
PMID:41960384 | PMC:PMC13057427 | DOI:10.3389/fpubh.2026.1766801
