{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:25:39Z","timestamp":1774430739680,"version":"3.50.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"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. Public Health"],"abstract":"\n Objective<\/jats:title>\n This study evaluated the effectiveness of a health education program based on the PRECEDE-PROCEED model in improving self-care, QOL, and biochemical outcomes among HD patients in Indonesia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A quasi-experimental study was conducted involving 90 HD patients allocated to intervention (\n n<\/jats:italic>\n \u202f=\u202f45) and control (\n n<\/jats:italic>\n \u202f=\u202f45) groups using a systematic assignment approach. The intervention group received an eight-session PRECEDE-PROCEED-based education program over 4 weeks, while the control group received standard care. Self-care was measured using the Chronic Kidney Disease Self-Management (CKDSM) Questionnaire, QOL was assessed using the SF-36, and biochemical outcomes were evaluated via serum urea and creatinine levels. Data were analyzed using appropriate parametric and non-parametric statistical tests, and effect sizes were calculated using Cohen\u2019s\n d<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Post-intervention, the intervention group showed significantly greater improvements in self-care (mean difference\u202f=\u202f18.33;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), QOL (mean difference\u202f=\u202f17.25;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and reductions in urea and creatinine levels (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001 and\n p<\/jats:italic>\n \u202f=\u202f0.006, respectively), compared to the control group. Large effect sizes were observed for self-care and QOL.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The PRECEDE-PROCEED\u2013based educational intervention was associated with improvements in self-care and quality of life, and with favorable short-term changes in selected clinical outcomes among patients undergoing hemodialysis.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1766801","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:53:33Z","timestamp":1774421613000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A PRECEDE-PROCEED-based educational program: enhancing self-care and quality of life with implications for biochemical outcomes in hemodialysis patients"],"prefix":"10.3389","volume":"14","author":[{"given":"Elly Lilianty","family":"Sjattar","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andina","family":"Setyawati","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aulia Insani","family":"Latif","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuurhidayat","family":"Jafar","sequence":"additional","affiliation":[{"name":"Department of Community Health Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuliana","family":"Syam","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]},{"name":"Department of Basic Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ummi Pratiwi","family":"Rimayanti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, Faculty of Nursing, Hasanuddin University","place":["Makassar, South Sulawesi, Indonesia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Fortwengel","sequence":"additional","affiliation":[{"name":"Department of Clinical Trial, Hochschule Hannover","place":["Hanover, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor Aziyan","family":"Binti Yahaya","sequence":"additional","affiliation":[{"name":"Department of Nursing Science, Faculty of Medicine, University of Malaya","place":["Kuala Lumpur, Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dnyanesh","family":"Limaye","sequence":"additional","affiliation":[{"name":"Department Research and Development, Center for Advancement in Health Sciences","place":["Pune, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita","family":"Hardianty","sequence":"additional","affiliation":[{"name":"Department of Nursing, Dr. Sulaiman Al Habib Medical Hospital Riyadh","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.3390\/life12081202","article-title":"Up-date on diabetic 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