EFFECTIVENESS OF WEB-BASED NUTRITION EDUCATION FOR CHRONIC KIDNEY DISEASE PATIENTS

Abstract

The aim of the study was to develop nutrition education website for chronic kidney disease (CKD) patients and to determine the effectiveness of this nutrition education tool. The first phase, a CKD knowledge and nutrition website was developed based on ADDIE model (analysis, design, development, implementation, and evaluation) and usability guidelines. To evaluate the website, 10 users were purposively selected to accomplish the specific tasks. The evaluation of website usability was conducted by questionnaire. The average scores of usefulness, ease of use, ease of learning, and satisfaction were somewhat agree - agree. After the website was improved, it was launched to the next phase. In the quasi-experimental phase, the developed website was implemented with CKD patients. The participants were CKD patients in the pre-dialysis stage (n = 44) who were enrolled on the educational website www.banraktai.com. Before the intervention, the participants had to complete personal information, food frequency questionnaire and eating behavior questionnaire, one-day dietary records, and a knowledge test. The participants accessed this website for 8 weeks. At week 4, they repeated doing one-day dietary records. At the end of the study, the participants completed eating behavior questionnaires and knowledge test again, as well as a website satisfaction form. After the intervention, the results showed that the participants had significant improvement both in knowledge scores and consumption behavior scores (p < 0.001 and p = 0.041 respectively). However, there was no correlation between nutrition knowledge scores and eating behavior scores. When considering the energy and nutrient intakes of the participants, there were no changes throughout the study, besides a significantly lower intake of sodium (p=0.005). Most participants were satisfied with the educational website (mean score = 3.98 ± 0.85), and the topic that the participants accessed most frequently was nutrition for CKD. This study indicates that the improvement of nutrition knowledge scores did not correlate with improvement of eating behavior. Web-based nutrition education may not be enough to encourage and motivate the CKD patients to make eating behavior change. However, the health educational website is a feasible alternative information source and may be beneficial for patients in learning and proper eating behavior modification.