Providing high energy and high protein snacks to improve dietary adherence and quality of life for hemodialysis patients

Introduction. Based on the number of patients who stopped hemodialysis treatment in 2017, 70% were dead. One factor influencing the high mortality rate is the poor quality of life because of a lack of dietary adherence that causes inadequate nutritional intake. Purpose: This study aims to determine the effect of providing high energy-protein snacks for improving dietary adherence and quality of life for hemodialysis patients. Method: This research was a pre-experimental study with one group pretest and posttest design. The number of samples in this study was 71. All study subjects were patients undergoing hemodialysis treatment at the Sardjito Hospital Yogyakarta. Patients got high energy-protein snacks twice a day for 21 days. We selected samples using a consecutive sampling method. Analysis of data used McNemar and Multiple Logistic Regression tests. Results:  This study showed no significant difference between pre and post dietary adherence after given snacks (p=0,32). There was a significant difference between pre and post quality of life score after a snack (p= 0,01). Multivariate analysis showed that energy intake (p=0,18;OR=0,21; CI=0,02-2,06), fat intake (p=0,95;OR=1,05;CI=0,25-4,38) and length of time hemodialysis periods (p=0,08;OR=0,2;CI=0,04-1,17) can predict the quality of life of hemodialysis patients (R2=0,106).  Conclusion: Providing snacks for hemodialysis patients help improve patients’ dietary intake and quality of life. However, it takes longer to change the habits of patients for snack consumption and improve dietary adherence.