title: Assessment and effects of Therapeutic Patient Education for patients in hemodialysis: a systematic review.
abstract: OBJECTIVE
  This review examined the impact of Therapeutic Patient Education (TPE) programs in hemodialysis and the assessment of these programs. REVIEW METHODS AND DATA SOURCES: A systematic review was performed. Bibliographical research was done with a database in the social and human sciences (PsychINFO, PsycARTICLES, SocINDEX with Full Text and the Psychology and Behavioural Sciences Collection). References were also searched in several reviews specialized in nephrology-dialysis and in patient education. Articles were classified according three different outcomes: (1) physiological outcomes, (2) psychosocial outcomes, (3) or combined criteria.
  
  
  RESULTS
  35 articles were selected. The majority dealt with purely physiological outcomes (18) and the minority concerned only psychosocial outcomes (4). Fifteen articles discussed both physiological and psychosocial outcomes, i.e. combined criteria. Beneficial effects were shown such as improvements in knowledge, adherence and quality of life. Most educational interventions were performed by nurses.
  
  
  CONCLUSIONS
  This systematic review found that educational programs in dialysis have become more numerous and efficient, with a prevalence of assessment based on physiological outcomes. TPE is a global management method based on both the physiological and the psychological well-being of the patient. Studies that take into account both physiological and psychosocial variables are very useful for understanding the effects of TPE programs on dialysis patients. The review shows that nurses play an important role in TPE and that they require varied communicational, educational, animation and assessment skills. These positive effects are encouraging for nurses to stimulate the development of TPE programs for dialysis patients in their multidisciplinary teams. The nurse's role is important for the commitment of each health caregiver (nurse, physician, dietician, pharmacist, psychologist, etc.) for the global management of patients in the TPE process.
authors.affiliation: Laboratory of Health Psychology and Quality of Life EA4139, University Bordeaux Segalen, 3 ter Place de la Victoire, 33076 Bordeaux Cedex, France. laetitia.idier@gmail.com
authors.forename: Laëtitia
authors.initials: L
authors.lastname: Idier
authors.forename: Aurélie
authors.initials: A
authors.lastname: Untas
authors.forename: Michèle
authors.initials: M
authors.lastname: Koleck
authors.forename: Philippe
authors.initials: P
authors.lastname: Chauveau
authors.forename: Nicole
authors.initials: N
authors.lastname: Rascle
mesh_terms: D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D006435:Renal Dialysis