title: Effects of systematic nursing instruction on a low-phosphorus diet, serum phosphorus level and pruritus of patients on haemodialysis.
abstract: OBJECTIVE
  To investigate the effectiveness of systematic nursing instruction on a low-phosphorus diet, serum phosphorus level and pruritus of haemodialysis patients.
  
  
  BACKGROUND
  A high number of end-stage renal disease patients on haemodialysis are bothered by pruritus. Hyperphosphataemia was reported to be related to pruritus.
  
  
  METHODS
  An experimental design was applied.
  
  
  METHODS
  Ninety-four patients who received haemodialysis between September 2013 and December 2013 at a medical centre in Taipei, Taiwan, were recruited. An experimental group received individual systematic nursing instruction by the investigator through a nursing instruction pamphlet and reminder card for taking medication. A control group received traditional nursing instruction. The pruritus, blood phosphorus level and five-day diet records were evaluated before and after intervention.
  
  
  RESULTS
  The experimental group had a low-phosphorus diet intake compared with the control group (p < 0·001). A significant difference in serum phosphorus level was observed between the experimental and control groups (p = 0·002). Incidence of pruritus was lower in the experimental group than in the control group (p < 0·001).
  
  
  CONCLUSIONS
  A systematic nursing instruction included using a pamphlet, pictures and reminder cards, the patients' blood phosphorus levels decreased, the patients consumed more low-phosphorus food, and pruritus decreased.
  
  
  CONCLUSIONS
  This study recommends that clinical nursing staff include systematic nursing instruction as a routine practice for dialysis patients.
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ting-Yin
authors.initials: TY
authors.lastname: Cheng
authors.affiliation: Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.|Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
authors.affiliation: School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yuan-Mei
authors.initials: YM
authors.lastname: Liao
authors.affiliation: Master Program in Long-term Care and School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Pi-Chu
authors.initials: PC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet; D018753:Diet, Protein-Restricted; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000379:methods*; D016226:Phosphorus, Dietary / Q000008:administration & dosage*; D011537:Pruritus / Q000178:diet therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications; D013624:Taiwan
chemical_list: D016226:Phosphorus, Dietary
keywords: pruritus; serum phosphorus level; systemic nursing instruction