The relationship between health locus of control and compliance of hemodialysis patients.

Abstract

Successful treatment of end stage renal disease (ESRD) depends on the patient compliance with therapeutic regimens. This descriptive study was conducted to examine the relationship between the health locus of control (HLC) orientation and compliance with therapeutic regimens. The convenience sample of 86 hemodialysis patients was obtained at two hemodialysis centers of teaching hospitals in southern Taiwan. A Demographic Questionnaire, the Multidimensional Health Locus of Control (MHLC) Scale, and Multimethod Compliance Assessment (including: Laboratory Assessment, Nurse Assessment, and Patient Self-report) were used to collect the data. The average overall rate of compliance with therapeutic regimen was 76.4% by patient self-report and 69.2% by nurse assessment. Examining the three compliance measures, patients were most compliant in following instructions for taking phosphate-binding medication (PBM) and least compliant in limiting fluid intake according to patient self-report and by nurses' assessment. The level of compliance for diet restriction fell between the other two measures. No significant correlations between the three subscales of the multidimensional health locus of control (MHLC) and composite compliance measures were found in this study, except that those with a high score on the subscale of powerful others locus of control were positively correlated with patient self-report (r = 0.388, p < 0.001) and with the laboratory assessment (r = 0.21, p < 0.01). This suggests that the MHLC construct had only a slight influence on measures of compliance in hemodialysis patients of Taiwan. Implications of findings for nursing practice, theory, and research are also discussed.