Objective: To study the intervention effect of rehabilitation nursing based on the change of motivation and behavior on hemodialysis patients, so as to provide basis for clinical diagnosis and nursing. Methods: Eighty patients with chronic renal failure who underwent hemodialysis in Wanbei Coal Power Group General Hospital from January 2018 to March 2019 were selected for the study. According to the random number table method, all patients were divided into control group and study group, 40 cases each. Patients in the control group were intervened by routine nursing mode. Patients in the study group adopted rehabilitation nursing intervention based on motivation behavior change on the basis of the routine nursing mode. Renal Adherence Altitudes Renal Questionnaire (RAAQ) and Renal Adherence Behavior Questionnaire (RABQ) scores, daily water consumption, 24 h urine volume, daily dietary water content, ultrafiltration volume, edema degree and dialysis adequacy of the two groups were compared. Results: Before intervention, there were no statistically significant difference between the two groups in the total scores RAAQ and RABQ (P>0.05). After intervention, total scores of RAAQ and RABQ of the two groups were significantly higher than those of the control group (P<0.05). Before intervention, there were no significant differences in daily water intake, 24-hour urine volume, daily dietary water content and ultrafiltration between the two groups (P>0.05). After intervention, the daily drinking water volume, 24-hour urine volume and daily dietary water content of the two groups were significantly reduced, and the ultrafiltration volume were significantly increased; the daily drinking water volume, 24-hour urine volume and daily dietary water content of the study group were significantly lower than those of the control group, and the ultrafiltration volume was significantly higher than that of the control group, with a statistically significant difference (all P<0.05). Before intervention, there was no significant difference in edema between the two groups (all P>0.05). After intervention, edema improved in both groups; edema in the study group was significantly lighter than in the control group (P<0.05). Before intervention, there were no significant differences in venous blood levels of urobilin (BUN) and serum creatinine (SCr) and Kt/V between the two groups (P>0.05). After intervention, venous blood levels of BUN and SCr were decreased, and Kt/V was significantly increased in the study group; venous blood levels of BUN and SCr in the study group were significantly lower, and Kt/V was significantly higher than those in the control group (all P<0.05). Conclusion: Rehabilitation nursing based on the change of motivation and behavior has a good intervention effect on hemodialysis patients, which can effectively improve the dialysis adequacy of patients, and improve patients’ participation and compliance.