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Abstract: PO2003

Walking in Patients' Shoes: Novel Approach to Increase Staff Empathy Through Adherence to Dietary Restrictions

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology


  • Razzouk, Randa, Cook Children's Medical Center, Fort Worth, Texas, United States
  • Cazzell, Mary, Cook Children's Medical Center, Fort Worth, Texas, United States
  • Marroquin, Amanda, Cook Children's Medical Center, Fort Worth, Texas, United States
  • Brown, Barrett, Cook Children's Medical Center, Fort Worth, Texas, United States

Dietary recommendations for children with end-stage renal disease (ESRD) on dialysis include restrictions in potassium, phosphorus, and sodium. Children must take phosphate binders with meals and snacks. Renal diet compliance can be challenged by adherence difficulties. Patient perceptions of health care professionals’ (HCPs) levels of empathy play an important role in improved patient satisfaction. Higher perceived empathy levels lead to improved patient compliance to treatment, diet, and overall positive health. The purpose of this study was to explore the impact of a novel intervention (adherence to a two-week renal diet) on levels of empathy among HCPs directly caring for children with ESRD on dialysis.


A quasi-experimental comparative interventional study design was utilized with a convenience sample of 37 HCPs who directly cared for children with ESRD on dialysis Through self-assignment, 14 HCPs completed a renal diet education class (control group); 23 completed the class and two-week renal diet and "phosphate binders" intake with logs (experimental group). Pre- and post-intervention levels of empathy were measured using the Jefferson Scale of Empathy. Renal diet logs were reviewed to calculate percentages of two-week compliance and “phosphate binder” use.


Baseline empathy scores for each group were matched (p=0.825). Within the experimental group, post-intervention results showed statistically significant increases in empathy levels after adherence to a two-week renal diet (p=0.004). No significant differences in control group pre- and post-empathy levels were noted. Percentages of compliance to a two-week renal diet were 82% and to “phosphate binders,” 83%.


Levels of empathy increased when HCPs followed a two-week renal diet, discovering similar patient adherence issues. HCPs reported less-than-perfect renal diet compliance and use of “phosphate binders.” This study can be implemented in various pediatric settings, such as specialty areas treating patients on therapeutic dietary restrictions (e.g. diabetes, celiac disease, epilepsy).

Results from experimental group
Renal Diet Log ItemsRenal Diet Class + 2- Week Renal Diet Trial ( n=23)
Percentage of Compliance to Renal DietMean(SD): 81.6 (11.39)%
Median: 80.5%
Range: 64-100%
Percentage of Compliance with Phosphate BindersMean(SD):82.75 (15.63)%
Median: 86.5%
Range: 37-100%
Percentage of Diet Log Record Keeping (out of 14 days)Mean(SD): 93.25 (20.93)%
Median: 100%
Range: 7-100%