The Impact of a Self-care Program Based on Orem's Self-Care Model on Psychological Self-Care Deficits in Hemodialysis Patients

Chronic renal failure and hemodialysis can lead to numerous self-care deficits in patients. Promotion of psychological self-care behaviors can help patients maintain their mental health and well-being. The present study was performed to determine the impact of a self-care program, based on Orem’s Self Care Model, on psychological self-care deficits in hemodialysis patients.

In this quasi-experimental study, carried out in 2013, thirty-six hemodialysis patients were selected via convenience sampling from the hemodialysis ward of Vali-e-Asr Hospital in Birjand, Iran. Data were collected, using a self-care deficit questionnaire, which was designed based on Orem’s Self-Care Model. After confirming its validity and reliability, the questionnaire was completed during interviews. By considering the subjects’ self-care deficits, the program was carried out via face-to-face interviews. One month after the intervention, the questionnaire was filled out again. Descriptive and inferential statistics were calculated by SPSS version 17. P-value ≤ 0.05 was considered statistically significant.

As the findings showed, psychological self-care deficits included knowledge deficit related to effective relaxation techniques and anger management via problem-solving, inability to use relaxation techniques and anger management via problem-solving, deficit in using positive sentences, deficit in expressing emotions toward family and friends, social isolation, grief, and despair. Before the intervention, the majority of patients (n=33, 91.7%) had knowledge deficit related to effective relaxation techniques, deficits in anger management via problem-solving, and inabilities to use relaxation techniques. However, after the intervention, the number of patients with knowledge deficit reduced to 13 (36.1%) (P< 0.001), and the number of subjects with deficits in using relaxation techniques decreased to 18 individuals (50%) (P=0.001), according to McNemar’s test.

The present study showed that a self-care program, based on Orem’s Self-Care Model, can significantly reduce psychological self-care deficits in hemodialysis patients. Therefore, nurses can apply self-care programs based on Orem’s Self-Care Model to improve patients’ mental health.