Effect of a Hydration Game-Based Learning Program in Improving Fluid Intake and Hydration Status in Institutional Residents

Abstract

Background: Approximately 50% of residents living in institutions have insufficient fluid intake, and 20%-30% experience dehydration. Implementing strategies that effectively increase fluid intake is crucial to preventing dehydration-related complications and reducing complications and comorbidities in this population.

Purpose: This study was designed to explore the effects on fluid intake and hydration status of a hydration game-based learning program in institutional residents.

Methods: A single-blind, cluster, randomized controlled trial was conducted. Sixty-four subjects from five long-term care facilities in northern Taiwan were randomly assigned to either an experimental or control group. The experimental group received a 40-minute game-based hydration care program intervention twice weekly for 8 weeks. The control group received routine care. The data obtained were analyzed using generalized estimating equation analysis to verify changes in observed variables in the two groups at 4 and 8 weeks (during and immediately after the intervention).

Results: The results showed a significant improvement in fluid intake in the experimental group at 4 and 8 weeks (p = .002 and p < .001, respectively). In terms of dehydration-related indicators, although total body water was significantly improved at 8 weeks in the experimental group (p = .009), no significant improvement was found in urine-specific gravity. In terms of signs of possible urinary tract infection, the experimental group showed significant improvement in urine leukocytes (p = .029) and nitrites (p = .004) at 8 weeks.

Conclusions/implications for practice: The findings of this study support the positive effects of applying the concept of uncertain rewards and game-based learning in institutional group activities. Specifically, the interventions increased social interaction and enhanced enjoyment of drinking. The findings call for nursing professionals at institutions to offer similar hydration game-based learning programs as part of residents' daily activities to improve fluid intake.