The risks and benefits of a treatment and its impact on the quality of life inform the decision-making of a patient. Patients can feel a lack of motivation to follow up on the treatment when the decisions do not align with the patients' values. There is confusion and lack of clarity about the importance of health education at Hamad medical corporation (HMC) to support the End-stage renal disease (ESRD) patient in deciding on treatment choices. Consequently, this raises many serious questions related to the obstacles to the success of the health education process at HMC.

A cross-sectional study using online questionnaires was conducted across six dialysis facilities at HMC. A pilot study was first conducted to standardize the study instrument. The empirical data collected via online questionnaires sent to 400 HMC dialysis staff members were analyzed using Statistical Package for Social Sciences version 17.0 for Windows (SPSS Inc., Chicago, IL). Rating scales of 0 (lowest) to 5 (highest) were used in this study. Moreover, descriptive statistics, frequencies, and tables were used to summarize and present the study results. Ethical clearance and official approval were obtained from the HMC research committee and the University of Essex, respectively.

Of the 148 respondents, 53.4% of them were female. The majority were 36-45 years old. In addition, 62.2% of respondents held a Bachelor of Science in Nursing degree, 54.8% were nephrologists, and 54.8% work at the Acute HGH dialysis unit.

This study showed that health education program (HEP) content and the quality of delivery method of the HEP content are relatively effective in enhancing decision-making for ESRD treatment choices for patients and their families at HMC. Similarly, the health education program is effective as a tool in decision making for ESRD treatment choices and for enhancing patients' decisions on ESRD treatment choices to reduce the mortality rate.

The obstacles to the successful implementation of health education programs at HMC include Language and communication barriers; Supportive environments; Patient and family health-related education; Lack of a patient-centred, structured health education program; Anxiety or stress from disease process; Patients' ignorance, level of education, attitudes and behaviours; Psychological problems and barriers; Medical team and staff support; Patients' non-compliance with treatment; COVID-19 related challenges.

The health practitioners at HMC believe that health educational tools and methods effectively manage end-stage kidney disease patients; also, improved 'Support Groups' and 'Audio-visual aids' are urgently needed at HMC for improved treatment outcomes for patients. The health practitioners at HMC facilities believe that hemodialysis at the center is the most effective ESRD treatment method amongst the available choices.

There is the need to establish a strategic plan to focus on the patient to involve him in the treatment plan with the surrounding variables that may affect the decision-making process and improve the effectiveness of the health education process at HMC. Novel approaches are recommended for development at HMC to reduce barriers to successful implementation and application of health educational tools, (e.g. improved 'Support Groups' and 'Online Contents') among dialysis staff in Qatar and improve patient decision making for the management of ESRD patients.