The effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions in elderly hemodialysis patients with low baseline health literacy.

Introduction: Adherence to renal dietary restrictions is an important method for minimizing complications in dialysis patients. This study aimed to investigate the effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions among elderly hemodialysis patients in Iran. Selected markers of diet and kidney function were also measured.

Methods: Sixty-nine elderly hemodialysis patients with a low level of health literacy were randomly divided into three groups: pictorial image education, teach-back education, and usual care (controls). The intervention groups received diet education comprising four 20-30 min sessions. Subsequently, nutrition knowledge was assessed in each of the three groups by questionnaire before and 2 months after the intervention. Blood laboratory indices were obtained from the patients' medical records and compared before and 2 months after the educational intervention.

Findings: There were significant differences in the mean nutritional knowledge scores between the two intervention groups and the controls (p < 0.001). Nutrition knowledge scores were higher after educational sessions incorporating images compared to those using a teach-back strategy.

Discussion: Nutrition educational strategies utilizing either pictorial images or teach-back techniques increased knowledge relating to renal nutrition.