Nutritional Indicators and Fluid Self-Efficacy Among Hemodialysis Patients in the Qassim Region, Saudi Arabia: A Multicenter Descriptive Cross-Sectional Study

Why It Matters

Low fluid self‑efficacy fuels non‑adherence, increasing hospitalization and mortality risk; addressing its predictors can enhance patient health and lower system costs.

Key Takeaways

• 59.5% of patients had low fluid self‑efficacy
• Female gender linked to higher self‑efficacy scores
• Longer dialysis duration predicts better fluid self‑efficacy
• Recent weight gain strongly predicts self‑efficacy levels
• Nurse‑led education recommended to boost adherence

Pulse Analysis

Managing chronic kidney disease hinges on strict fluid control, especially for patients on hemodialysis. Fluid self‑efficacy—a patient’s confidence in adhering to fluid‑restriction guidelines—directly influences daily intake decisions, interdialytic weight gain, and ultimately cardiovascular stability. While clinical protocols dictate precise fluid limits, the psychological component often determines whether patients can consistently meet those targets, making self‑efficacy a critical lever for clinicians seeking to reduce complications and improve quality of life.

The Qassim study adds nuance to this paradigm by quantifying self‑efficacy levels across a diverse cohort and identifying key predictors. Women reported higher confidence than men, suggesting cultural or behavioral factors may shape adherence patterns. Moreover, patients with longer dialysis exposure demonstrated improved self‑efficacy, likely reflecting accumulated mastery experiences and routine reinforcement. Notably, recent weight gain—a proxy for fluid overload—emerged as the strongest predictor, underscoring the feedback loop between observable clinical outcomes and patient confidence. These findings align with global research linking longer treatment duration and tailored education to better self‑management, while also highlighting gender‑specific gaps that merit targeted interventions.

For healthcare systems, the implications are clear: integrating structured, nurse‑led education that leverages Bandura’s self‑efficacy theory can transform patient behavior. Practical tools such as fluid‑intake logs, digital reminders, and personalized counseling can reinforce mastery experiences and verbal persuasion, especially for male patients who may lag in confidence. Policymakers should consider funding multidisciplinary programs that routinely assess self‑efficacy alongside nutritional metrics, enabling early identification of at‑risk individuals. Future research should expand beyond cross‑sectional designs to longitudinal trials, incorporating psychosocial variables like depression and social support to fully map the determinants of fluid self‑efficacy in dialysis populations.