Patients undergoing hemodialysis (HD) due to chronic kidney failure are the group at risk for

the COVID-19 epidemic, which affects the whole world, due to conditions such as suppression

of the immune system, malnutrition and limited fluid intake. In patients undergoing HD, fluid

restriction, following dietary recommendations, using medicationsregularly, and undergoing

dialysis at planned intervals for the prescribed time are important components of treatment.

It raises the concern that HD patients, who have limited social life associated with the treatment process, will be more restricted with the quarantine conditions applied at the time of the pandemic, and this situation will negatively affect the patients psychologically, socially, and physically. It is thought that during this current epidemic process, the treatment of patients

may be disrupted and this may lead to the emergence of psychopathological problems such as

anxiety. Since it is not possible to meet face-to-face due to quarantine measures, maintaining

health services throughtelehealth services can be considered a method used to minimize the

risk of COVID-19 in patients and to continue their treatment optimally.

The experimental study was conducted on a total of 60 patients, 30 of whom were interventions

and 30 were controls, in the Hemodialysis Unit of Sivas Cumhuriyet University Hospital. The

patients were selected by a simple randomization method according to their dialysis days,

and the single-blind method was applied so that the patients did not know which group they

were in. Therefore, patients who underwent dialysis on Monday-Wednesday-Friday were

included in the Intervention Group, and patients who underwent dialysis on Tuesday-Thursday-Saturday were included in the study as the Control Group. In the first encounter, patients were informed about the work to be done in the dialysis unit, and the Patient Information Form, Dialysis Diet and Fluid Restriction Non-Compliance Scale, Beck Anxiety Scale, Modified Morisky Scale were applied and the individual’s clinical parameters were recorded for the Patient Clinical Parameters Form from the patient’s file. Weekly phone calls were planned, the patientswere called once a week for 12 weeks, and a follow-up evaluation form was applied by phone. In line with the needs of the patients, training was given about diet and fluid restriction. The painting activity was applied twice a week, for 30 minutes daily. DialysisDiet and Fluid Restriction Non-Compliance Scale, Beck Anxiety Scale and Modified Morisky Scale were administered to the patients at the 1st, 6th and 12th weeks of the administration, and clinical parameters were recorded from the patient file. The scales were applied to the Control Group patients at the 1st, 6th and 12th weeks and the clinical parameters of the patient were recorded.

As a result of the education and art therapy application made with the telehealth method as

a result of the project; SBP, DBP, HD entry weight, creatinine values, frequency and degree of non-compliance with diet, frequency of non-compliance with fluid restriction, and anxiety levels of patients in the intervention group receiving hemodialysis treatment decreased and their compliance increased. It is critically important to support patients receiving hemodialysis treatment with education with an interdisciplinary approach and art therapy with a multidisciplinary approach during the Covid-19 pandemic period.

Keywords: anxiety, COVID-19, dietary fluid restriction, hemodialysis, telehealth