Abstract
PurposeThis study aimed to identify the factors related to treatment adherence behaviors among old-age hemodialysis patients in Hamadan based on the Extended Theory of Planned Behavior (ETPB) during the covid-19 pandemic.MethodsThis cross-sectional study was conducted from January to March 2021 in Hamadan, Iran. 191 hemodialysis patients were recruited who were referred to hemodialysis centers via the census method. Data were collected by a questionnaire containing items on socio-demographic information, End-Stage Renal Disease Adherence (ESRD-Adherence) Questionnaire, and ETPB constructs scale. Data analysis was performed using descriptive statistics and structural equation modeling.ResultsThe mean (SD) age of participants was 62.49 (10.66). Also, the mean (SD) hemodialysis vintage/Month of them was 36.56 (43.34). Moreover, Treatment Adherence Behaviors are associated with education level, sex, and marital status (p < 0.001). Besides, Perceive Behavior Control (β = 0.414, t-value = 3.810) associated with intention. Also, intention (β = 0.158, t-value = 1.976) was associated to adherence behaviors. No significant associations were observed between positive attitudes, subjective norms, a perceived threat with intention, and adherence behaviors. The model explained about 54% of the variance of adherence behaviors. Finally, the goodness of fit index of 0.78, indicating the model good fit.ConclusionThe present study demonstrates that some of the ETPB constructs such as perceived behavior control and intention are useful to improve adherence among the oldest hemodialysis patients. Also. This framework is revealed alongside the theory of planned behavior (TPB) applicable in the treatment adherence of old-age hemodialysis patients.
Highlights
Chronic kidney failure is one of the most common noncommunicable diseases that occurs during the progressive process of decreased nephron function
Adherence to hemodialysis (HD) for patients with end-stage renal disease is essential and leads to lifestyle changes such as the need to regularly go to a dialysis center, consistently take prescribed medications, and extensively modify their diets [3]
The present study aimed to identify factors related to treatment adherence behaviors among older HD patients in Hamadan, Iran, based on Extended Theory of Planned Behavior (ETPB)
Summary
Chronic kidney failure is one of the most common noncommunicable diseases that occurs during the progressive process of decreased nephron function. According to the World Health Organization, treatment adherence is the correspondence level of a person receiving medication, following a prescriptive diet, or implementing lifestyle changes due to healthcare providers’ recommendations [2]. Adherence to hemodialysis (HD) for patients with end-stage renal disease is essential and leads to lifestyle changes such as the need to regularly go to a dialysis center, consistently take prescribed medications, and extensively modify their diets [3]. Management of renal replacement therapy includes behaviors such as HD attendance, medications, fluid restrictions, and diet prescription [4, 5]. The result of the study indicated that HD patients needed complex care to manage this chronic disease [6]. A study matched with the Iranian context showed that it was essential to identify factors effective for treatment adherence in HD patients [7]
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