Abstract

Patients receiving maintenance hemodialysis carry a heavy burden of symptoms, psychological stress and treatment demands, yet structured, nurse-delivered programmes remain scarce in India. This quasi-experimental, pre-test–post-test repeated-measures study with a control group evaluated a multicomponent nurse-led clinical intervention (NLCI) for hemodialysis patients in a tertiary-care dialysis unit in Mandya, Karnataka. A total of 120 patients (60 intervention, 60 control; no attrition) were allocated purposively by dialysis day. The intervention comprised a structured video teaching programme in Kannada (40 min), a supervised practice session of yoga and breathing meditation (20 min), individualised teaching and counselling, dietitian-led dietary counselling and weekly follow-up; controls received routine care. Knowledge, physiological indicators, perceived stress, coping, quality of life (KDQOL-SF) and symptom burden (Dialysis Symptom Index) were measured at baseline and at 6, 12 and 24 weeks. Groups were comparable at baseline except for occupation. Mean knowledge rose from 9.47 to 25.98 at 6 weeks and remained at 25.20 at 24 weeks in the intervention group, whereas the control group stayed near baseline (between-group F = 1384.34, p = 0.001). Symptom burden fell from 98.80 to 37.00 in the intervention group and was unchanged in controls (97.55 to 96.85; between-group F = 3102.99, p = 0.001). Stress decreased and coping increased significantly more in the intervention group, while quality of life did not differ between groups (p = 0.77). Physiological effects were mixed: between-group differences emerged for systolic and diastolic blood pressure, BMI, phosphorus and haemoglobin but not for sodium, potassium, calcium, urea clearance or dialysis adequacy. Because allocation was non-random, these findings should be treated as preliminary; they nevertheless support integrating structured, nurse-led education, relaxation and counselling into routine hemodialysis care and justify a randomised trial.