154 Journal of Pharmacy and Nutrition Sciences, 2018, 8, 154-162
ISSN: 2223-3806 / E-ISSN: 1927-5951/18 © 2018 SET Publisher
Effectiveness of Web-Based Nutrition Education for Chronic
Kidney Disease Patients
Suyanee Pongthananikorn
*
, Jitprasong Lamsaard and Tippawan Siritientong
Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn
University, Bangkok, Thailand
Abstract: Background: In the early stages of chronic kidney disease (CKD), encouraging health behaviors can help
prevent the progression of kidney disease leading to eventual kidney failure. The studies of health education using
computer technology have been greatly developed, especially web-based nutrition education.
Objective: To determine the effectiveness of a nutrition education website for CKD patients.
Method: The design of this quasi-experimental research was a group pre-test/post-test. The participants were pre-
dialysis CKD patients who were enrolled on the developed website www.banraktai.com. The participants were required
to complete an eating behavior questionnaire and knowledge test. They accessed the website for eight weeks, and at
week 8, they completed the eating behavior questionnaire and knowledge test again. The main outcomes were the
changes in scores of nutrition knowledge and eating behavior that were compared between the baseline and after the
intervention using the paired t-test. The correlation between nutrition knowledge scores and eating behavior scores was
determined using Spearman’s correlation coefficient.
Results: There were 44 participants that completed the study. The results showed that the participants had significant
improvement in both knowledge scores and consumption behavior scores (p < 0.001 and p = 0.041, respectively).
However, there was no correlation between the nutrition knowledge scores and the eating behavior scores.
Conclusions: Web-based nutrition education can improve knowledge scores but is not effective enough to encourage
and motivate CKD patients to make eating behavior changes.
Keywords: Chronic kidney disease, web-based nutrition education, patient education, nutrition knowledge, eating
behavior.
INTRODUCTION
Chronic kidney disease (CKD) is a major public
health problem, of which the prevalence and rate of
incidence in the past few years have been increasing in
Thailand. In the early stages of CKD, encouraging
health behaviors can help prevent the progression of
kidney disease that leads to eventual kidney failure.
Promoting positive behaviors, such as proper nutrition,
physical activity, maintenance of optimal levels of blood
sugar and lipid profile, are important methods for
patients to slow down the loss of kidney function.
Therefore, CKD patients should also have general
knowledge of CKD and be aware of their individual
risks [1]. However, according to several studies, only a
small number of patients can appropriately answer the
questions regarding basic etiology prognosis and
treatment of CKD. Some patients and families are
unable to remember medical information regarding how
to prevent kidney failure. Most CKD patients neither
know the stage of their kidney disease nor know how to
slow the progression of the disease [1-5].
*Address correspondence to this author at 254 Phyathai Road, Pathumwan,
Bangkok 10330, Thailand; Tel: (+66)2-218-8297;
E-mail: suyanee.p@chula.ac.th
Consequently, poor nutrition and health care in CKD
patients results in bad practice, and also causes
negative health effects.
The use of technology has changed the way that
patients learn about health and nutrition. There are
many nutrition and health education studies available
for patients using computer technology. According to
Wedman’s study [6], an interactive videodisc (IVD) on
dietary restrictions for hemodialysis patients was
developed. This study showed that most participants
improved their health behaviors, including compliance
with sodium restriction, fluid modification, and protein
serving size reduction. In addition, McMahon et al. [7]
has shown that diabetic participants who received web-
based care management had a significantly lower
glycosylated hemoglobin (HbA
1C
) when compared to
the baseline. Later, development of a computer-
assisted instruction (CAI) program on dietary control
was applied to prevent ischemic heart disease among
people with high levels of risk. It was found that this
intervention could significantly improve the participants’
post-test knowledge scores [8]. In Thailand, the studies
on health education using computer technology have
been greatly developed. However, there are few
developed tools that can efficiently be applied to