A Theory-based Fluid Self-management Program

This study aims to evaluate the efficacy of an intervention guided by the IFSMT, in which structured education and digitally delivered reinforcement strategies are designed to enhance self-management processes, including knowledge and beliefs, self-regulation skills, and social facilitation, among patients undergoing maintenance hemodialysis. The intervention, delivered via a mobile platform three times daily over two months, seeks to improve fluid control adherence and hemodialysis self-management behaviours, and to reduce interdialytic weight gain and stabilise pre-hemodialysis mean arterial pressure, compared with standard education alone.

Inclusion Criteria: * Receiving maintenance hemodialysis for ≥ 3 months * Undergoing hemodialysis two times per week on a regular schedule * Possession of a smartphone with active WhatsApp use * Ability to read and understand Indonesian, with support provided in Javanese where necessary. * Provision of written informed consent Exclusion Criteria: * Severe cognitive impairment or diagnosed psychiatric disorders affecting comprehension or participation, as documented in the medical record. * Severe visual, hearing, or communication impairments not corrected by assistive devices * Current hospitalisation or unstable medical condition * Planned kidney transplantation or dialysis modality change during the study period * Participation in another interventional study related to fluid management or self-management * Inability to engage with the WhatsApp Channel follow-up