{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:45:42Z","timestamp":1784040342572,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemodialysis is a life-sustaining renal replacement therapy that removes metabolic waste products normally eliminated by the kidneys. Patients undergoing hemodialysis are required to adhere to strict fluid and dietary restrictions to prevent serious complications. Fluid self-efficacy is a key determinant of adherence, as it enhances motivation, supports emotional regulation, and promotes engagement in health-related behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate nutritional indicators and fluid self-efficacy among hemodialysis patients in Qassim Region, Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive cross-sectional study was conducted within 4\u202fmonths using a convenience sample of 200 adult hemodialysis patients recruited from five dialysis centers across three major cities in Qassim region, Saudi Arabia, namely Buraydah, Unaizah, and Al-Rass. Data collection tools were adapted and consisted of four main parts: socio-demographic characteristics, hemodialysis history, nutritional parameters, and fluid self-efficacy, in addition to anthropometric measurements. Data were analyzed using SPSS version 20.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 59.5% of participants demonstrated low fluid self-efficacy, with a Mean\u202f\u00b1\u202fSD of 17.0\u202f\u00b1\u202f6.57 and an average item score of 1.70\u202f\u00b1\u202f0.66. A statistically significant relationship was found between nutritional indicators and duration of hemodialysis, specifically regarding weight change over the last 6\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035). Additionally, gender showed a significant association with fluid self-efficacy (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hemodialysis patients exhibited generally low levels of fluid self-efficacy, with weight changes over 6\u202fmonths and gender identified as significant associated factors. These findings provide preliminary evidence that behavioral, nutritional, and psychosocial factors may be associated with self-efficacy and adherence. The results highlight the potential importance of integrating targeted patient education, structured behavioral interventions, and continuous nursing support to enhance self-efficacy and promote adherence to fluid. Tailored, nurse-led strategies incorporating individualized counselling and supportive monitoring to improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1820274","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:28:59Z","timestamp":1781065739000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nutritional indicators and fluid self-efficacy among hemodialysis patients in the Qassim region, Saudi Arabia: a multicenter descriptive cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Fatma Mohamed","family":"Elmansy","sequence":"first","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Department of Nursing, Medical City, Qassim University","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Goda","family":"Elbqry","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Department of Nursing, Medical City, Qassim University","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen Ahmed A.","family":"Qalawa","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa A.","family":"AlQasem","sequence":"additional","affiliation":[{"name":"Privatization Affairs Office-Ministry of Health","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid Ali","family":"Alotni","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muneera","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer Yahia Mahdy","family":"Shalby","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, Najran University","place":["Najran, Saudi Arabia"]},{"name":"Department of Medical-Surgical Nursing, Faculty of Nursing, Banha University","place":["Banha, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12882-016-0257-z","article-title":"Dialysis-related factors affecting self-efficacy and quality of life in patients on haemodialysis: a cross-sectional study from Palestine","volume":"17","author":"Mousa","year":"2018","journal-title":"Ren Replace Ther"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"153","DOI":"10.2174\/0113892029300247240325080421","article-title":"Genomics in diabetic kidney disease: a 2024 update","volume":"25","author":"Roumeliotis","year":"2024","journal-title":"Curr Genomics"},{"key":"ref3","volume-title":"The Relationship of Self-Efficacy with Adherence in Restricting Fluid Intake in Middle Adult Hemodialysis Patients. 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