Comparison of video to patient education pamphlet in improving patients’ knowledge, beliefs, perceived and actual adherence to femoral non-tunnelled dialysis catheter care among haemodialysis patients

Background: Patients with femoral non-tunnelled dialysis catheters (NTDC) are at high risk of mechanical complications, including kinking and dislodgement. A Health Belief Model–based pamphlet (HBM-PEP) improved knowledge and adherence but may be less accessible for patients with low health literacy. A video-based education intervention (VBEI), combining visual and auditory elements, may enhance comprehension and recall. Objective: To compare the effectiveness of HBM-PEP versus HBM-VBEI in improving knowledge, beliefs, perceived adherence and actual adherence to femoral NTDC care among haemodialysis patients. Design: Single-centre historical control design. Participants: Adult haemodialysis patients with femoral NTDC. The historical PEP group received HBM-PEP in a prior study by the same team, while the HBM-VBEI group received the video-based intervention. Measurements: Self-developed 29-item questionnaire and adherence charts. Results: One hundred participants were recruited (50 HBM-PEP, 50 HBM-VBEI). Compared with HBM-PEP, the HBM-VBEI group showed significantly higher recall of NTDC care guidelines ( p < 0.001), greater perceived knowledge ( p < 0.001) and higher actual adherence ( p < 0.001). Recall of guidelines showed a moderate positive correlation with perceived knowledge ( r = 0.593, p < 0.001) and low positive correlations with perceived adherence ( r = 0.233, p = 0.002) and actual adherence ( r = 0.233, p = 0.002). Perceived knowledge demonstrated a moderate positive correlation with actual adherence ( r = 0.395, p < 0.001). Multiple linear regression analysis identified tertiary education level ( B = 0.72, p = 0.02), minimal assistance ( B = 0.45, p = 0.01) and use of VBEI ( B = 0.87, p < 0.001) as significant predictors of actual adherence to femoral NTDC care. Conclusions: HBM-VBEI improved perceived knowledge, guideline recall and adherence to femoral NTDC care, potentially reducing the risk of catheter-related mechanical complications.