the effects of a self-management program on fatigue, treatment adherence and sleep quality in patients undergoing hemodialysis: a quasi-experimental study

Background: hemodialysis patients experience a wide range of physical and psychological challenges that can negatively impact their quality of life, including fatigue, poor treatment adherence, and disrupted sleep patterns. objectives: this study aimed to determine the impact of a self-management program on fatigue, treatment adherence, and sleep quality in hemodialysis patients. methods: this quasi-experimental study, utilizing a pre-test-post-test design with a control group, was conducted in zahedan teaching hospitals in 2021. a total of 60 hemodialysis patients were recruited through convenience sampling and non-randomly allocated to either the intervention (n = 30) or control group (n = 30). the intervention group participated in a self-management program, which included four educational sessions during hemodialysis. the control group received routine care without any intervention. data were collected at baseline, one month, and three months after the intervention using the multidimensional fatigue inventory (mfi-20), end-stage renal disease adherence questionnaire (esrd-aq), and pittsburgh sleep quality index (psqi). data analysis was performed using chi-square, independent t-test, anova, and f test with spss version 16 and r version 3.0.1. a significance level of p < 0.05 was considered. results: the mean sleep quality scores showed no significant difference between the intervention and control groups at any time point (p = 0.636), and the main effects of time, group, and their interaction were not statistically significant. similarly, fatigue scores did not show significant differences over time (p = 0.234), between groups (p = 0.375), or in the time-group interaction (p = 0.350). however, in terms of treatment adherence, while the main effects of time (p = 0.083) and the time-group interaction (p = 0.155) were not significant, a significant difference was observed between the groups (p = 0.013), indicating improved adherence in the intervention group compared to the control group. conclusions: the self-management program had a positive effect on treatment adherence but did not lead to significant improvements in fatigue or sleep quality among hemodialysis patients. given the chronic nature of the disease and the multifactorial influences on sleep and fatigue, future studies with larger sample sizes and longer follow-up periods are recommended to assess the long-term effectiveness of self-management interventions in this population.