Compliance In Hemodialysis Patients Research Articles

Effect of the LEARNS Model on Self-Care Agency and Compliance in Hemodialysis Patients with Fluid Overload

Objective: To explore an intervention strategy for patients with fluid overload undergoing maintenance hemodialysis and to evaluate the effects of the LEARNS model on improving self-care agency and patient compliance. Methods: A total of 76 patients with fluid overload undergoing maintenance hemodialysis at our hospital from March 2023 to March 2024 were selected for the study. Patients were randomly divided into two groups, with 38 in each group. The control group received conventional interventions, while the observation group was treated using the LEARNS model. Self-care agency, compliance, and quality of life outcomes in both groups were analyzed and compared. Results: Before the intervention, no statistically significant differences were observed in the self-care agency scores between the two groups (P > 0.05). After the intervention, patients’ self-care agency improved significantly, with the observation group showing notably higher scores than the control group (P < 0.05). Patient compliance in the observation group was also significantly higher than in the control group (P < 0.05). Quality of life, assessed using the SF-36 scale, showed no significant differences between the two groups prior to intervention (P > 0.05). After the intervention, quality of life scores improved significantly in both groups, with the observation group exhibiting significantly higher scores than the control group (P < 0.05). Conclusion: The LEARNS model is effective in improving patient compliance, enhancing self-care agency, and improving quality of life in maintenance hemodialysis patients with fluid overload, making it a promising approach for broader application.

Effect of Educational Intervention on Adherence of Treatment in Hemodialysis Patients

Background: Adherence to treatment plans and prescribed drugs is considered an important challenge in chronic patients, and non-adherence to the treatment plan in these patients causes worsening of the condition of the disease and a decrease in their quality of life. Therefore, this study was conducted with the aim of determining the effect of self-care program training on treatment compliance in hemodialysis patients. Methods: The present study was a Quasi-experiment study in which all eligible patients of the hemodialysis department of Sanandaj were selected by census method in two intervention and control groups. In two groups, before and one month after the intervention, a demographic questionnaire and a questionnaire of adherence to the treatment of kidney patients were completed. The intervention included three training sessions as well as a training booklet for the ward. But in the control group, the patients received the necessary care according to routine. Data were analyzed using spss-16 software and descriptive tests and Wilcoxon and Mann-Whitney non-parametric tests. Results: The results of the study showed that the average age and standard deviation of the participants was 51.71±15.85 years and the participants were homogenous in both groups. The average total score of treatment adherence in the intervention group increased from 93.03±12.77 before the intervention to 105.23±24.39 after the intervention (P<0.05); However, in the control group before and after the intervention, the results of the Wilcoxon test did not show a significant difference. Conclusion: The program training and training for patients has led to an increase in patients’ awareness, improved patient care, and comprehensively and accurately points out all the information related to the patient’s condition, and provides them with the opportunity to ask and answer questions with nurses.

Association between caregiver burden in family and hemodialysis compliance of chronic kidney disease patients in Aceh, Indonesia.

Patient compliance toward undergoing treatment determines its success rate. Unfortunately, the compliance among hemodialysis patients is concerning. Supports from family has been suggested influence the patient compliance, especially from a family member who acts as a caregiver. The aim of this study was to determine the association between the level of caregiver burden and compliance in hemodialysis patients. A cross-sectional study was conducted at Dialysis Installation at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. The study sample was family members who accompanied hemodialysis patients. The minimal number of patients was determined of which 67 respondents were required and therefore recruited. Caregiver burden was collected using direct interview using Caregiver Burden Assessment questionnaire. The results revealed that twenty-four respondents (35.8%) had moderate caregiver burden, while there were only nine respondents (13.4%) had very low caregiver burden. The majority of the hemodialysis patients were non-compliant (n=38, 56.7%). A Chi-squared test indicated a significant association between the status of caregiver burden and the patient compliance to hemodialysis (p=0.011). These findings stress the importance of addressing caregiver burden in ensuring the compliance of patients receiving hemodialysis.

Faktor-Faktor yang Berhubungan Dengan Tingkat kepatuhan pasien PGK dalam menjalani hemodialisis.

Introduction: one of the non-communicable diseases that has become a global health problem, namely chronic kidney disease (CKD) is a slow, progressive and irreversible deterioration of kidney function that causes the kidneys to be unable to get rid of waste products. requires renal replacement therapy/hemodialysis/dialysis. Hemodialysis is one of the therapies to remove toxic substances and excess water from the body. The purpose of this study was to determine the factors related to the compliance of kidney disease patients in undergoing hemodialysis treatment in the hemodialysis unit room of arifin achmad hospital. Methods: This study used a descriptive correlative design with a cross sectional approach. The research sample was 58 respondents using purposive sampling technique. This study uses a questionnaire that has been tested for validity and reliability. The analysis used is univariate analysis and bivariate analysis. Results: the results of univariate analysis showed that most of the respondents were middle-aged adults (41-65 years) (81.0%), male gender (53.4%), the education level of the respondents was greater than high school (39.7%), the duration of hemodialysis most of them are 4 years old (70.7%), the respondent’s motivation is mostly high (58,3%), the respondent’s family support is mostly good (70.7%), access to health services, most respondents are easy (79,3%) and the majority of respondents are obedient (77,6%). The person chi-square test showed factors of knowledge (p=0,000), motivation (p=0,0020), family support (p=0,027) and access to health services (p=0,308). Conclusion: there is a significant relationship between knowledge, motivation, and family support with chronic kidney disease patient compliance in undergoing hemodialysis. Knowledge is the most powerful factor associated with this hemodialysis patient compliance. And there is no significant relationship between access to health services with chronic kidney disease patient compliance in undergoing hemodialysis.

Association between Attitudes to Self Management on Adherence in Restriction Fluid and Dietary among Patient Hemodialysis Related to Hypervolemia

This study aims to determine the relationship between hemodialysis patients' attitudes toward self-management and adherence to fluid restriction and hemodialysis diet related to hypervolemia. This research method is a Literature review. The data used in this study comes from reputable journal articles published nationally and internationally in national and international online journals. The results showed that the risk of hypervolemia was reduced when patients could manage their health by performing self-care, developing a self-management plan, and modifying initial diet and renal fluid instructions to adapt to their lifestyle. In conclusion, there is a relationship between self-management and compliance of hemodialysis patients with fluid and dietary restrictions, especially sodium.
 
 Keywords: Compliance, Self Management, Fluid Restriction, and Diet

Evaluation of the relationship between COVID-19 anxiety and treatment compliance in hemodialysis patients: A prospective, descriptive study.

IntroductionIt is aimed in this study to evaluate the relationship between COVID‐19 anxiety and treatment compliance in hemodialysis patients.MethodsThis study was conducted descriptively with 128 hemodialysis patients treated in the hemodialysis unit of a district state hospital between September and December 2021.ResultsIt was observed that there was a significant relationship between the dialysis duration as well as the variable of forgetting to take their medicines while traveling and the coronavirus anxiety scores according to the multiple regression analysis regarding the variables affecting the coronavirus anxiety levels of the participants, and that these two variables were 25% determinant in the mean score of the coronavirus anxiety (R 2 = 0.25, p = 0.00).ConclusionIt was found, as a conclusion, that the majority of the patients were compliant to the treatment and such variables as gender, education, profession, and dialysis duration were related to the coronavirus anxiety.

Development of a Predictive Nomogram for Estimating Medication Nonadherence in Hemodialysis Patients.

BackgroundMedication compliance in hemodialysis patients affects the therapeutic effect of treatment and patient survival. Therefore, we aimed to explore the influencing factors of medication adherence in hemodialysis patients and develop a nomogram model to predict medication adherence.Material/MethodsData from questionnaires on medication adherence in hemodialysis patients were collected in Chengde from May 2020 to December 2020. The least absolute selection operator (LASSO) regression model and multivariable logistic regression analysis were used to analyze the risk factors for medication adherence in hemodialysis patients, and then a nomogram model was established. The bootstrap method was applied for internal validation. The concordance index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), decision curve analysis (DCA), calibration curve, net reclassification improvement (NRI) index, and integrated discrimination improvement (IDI) index were used to evaluate the degree of differentiation and accuracy of the nomogram model, and clinical impact was used to investigate the potential clinical value of the nomogram model.ResultsIn total, 206 patients were included in this study, with a rate of medication nonadherence of 41.75%. Eight predictors were identified to build the nomogram model. The C-index, AUC, DCA, calibration curve, NRI, and IDI showed that the model had good discrimination and accuracy. The clinical impact plot showed that the nomogram of medication adherence in hemodialysis patients had clinical application value.ConclusionsWe developed and validated a nomogram model that is intuitive to apply for predicting medication adherence in hemodialysis patients.

THE EFFECT OF VIRTUAL EDUCATION TO IMPROVE COMPLIANCE OF HEMODIALISYS PATIENTS WITH HEALTH PROTOCOLS DURING PANDEMIC

Background: The spread of COVID-19 has continued to increase since March 2020. Patients with chronic kidney failure who undergo Hemodialysis are one of the groups vulnerable to COVID-19 because they routinely undergo Hemodialysis. One of the ways to prevent transmission of COVID-19 to hemodialysis patients is by providing education to comply with the COVID-19 prevention Health protocol.
 Objective: The purpose of this study was to determine the effect of virtual education on Hemodialysis patient compliance in preventing covid-19 transmission at the Muhammadiyah Hospital in Lamongan.
 Methods: This study used the Pre-Experiment approach one group pre-test post-test design on all CKD patients who were routine Hemodialysis at Muhammadiyah Lamongan Hospital from October - December 2020 who were taken using the purposive sampling technique. The intervention given was playing educational videos for 2 months. Data were collected using a questionnaire before and after the intervention, which was tested by the Wilcoxon test with α <0.05.
 Results: There were 69 patients who took part in the entire processes until it was completed. The results revealed that there were differences in the level of compliance of hemodialysis patients before and after treatment (p = 0.000). Further research with larger sample and RCT design is needed for stronger generalization in population.
 Conclusion: Providing educational videos can increase the level of compliance of hemodialysis patients in implementing Health protocols to prevent transmission of COVID-19.

ADHERENCE OF SELF-CARE MANAGEMENT AMONG HEMODIALYSIS PATIENTS

Chronic kidney disease (CKD) has a high prevalence and incidence so that it is a frequent global problem. CKD causes kidney tissue damage which is marked by the accumulation of metabolic waste in the blood so it is necessary to do kidney replacement therapy, one of which is hemodialysis. CKD has 5 stages based on the glomerular filtration rate, wherein each stage the patient must be responsible for managing his health such as diet and lifestyle modification, administering large amounts of medication, and complying with doctor's rules. Therefore, patients must increase their adherence to self-care management so that they can prevent the worsening of the disease. This study aims to determine adherence of self-care management among hemodialysis patients. The research design used a quantitative descriptive with a cross-sectional approach. The sample in this study was 84 patients who underwent hemodialysis at the Majalaya Hospital, and they were taken by consecutive sampling technique from a population of 145 people. The instrument used in this study was Morisky questionnaire, Body Mass Index, Hemodialysis Self-Management Instrument (HDSMI), IDWG (Interdialytic Weight Gain). Data analysis was done using statistical software to obtain frequency distribution. The results showed that the compliance of hemodialysis patients in taking medication was still low, 50% (42 respondents), 72.6% (61 respondents) did not comply with the diet, 61.9% (52 respondents) did not comply with fluid intake, 53.6% (45 respondents) were not obedient in caring for AV fistula. This result can be influenced by several factors, namely education, gender, marital status, age, length of HD. Adherence to self-care management it is very important because it greatly influences the management of complications, controlling symptoms, minimizing negative effects, and delaying disease progression.

The effect of implementing collaborative care model on diet compliance in hemodialysis patients

Non-compliance to diet and increased fluid intake can lead to unpleasant side effects and premature mortality in hemodialysis patients. Intervention strategies in educational and cognitive-behavioral domains can be used to improve diet compliance and restrict fluid intake in hemodialysis patients. The present study aimed to implement a participatory care model on diet compliance in patients undergoing hemodialysis referred to the Urmia Hemodialysis Center of Urmia in 1397. The present study is an experimental-randomized study that was performed on 60 patients undergoing diet without hemodialysis referring to Urmia Hemodialysis Center of Urmia. From 175 patients undergoing hemodialysis based on laboratory parameters of non-compliance patients and 60 patients were selected based on simple randomization and were randomly divided into intervention and control groups. After intervention steps of participatory care, diet compliance of the two groups was compared using the results of the comparable laboratory parameters. Analysis of the results of the present study showed that the collaborative care model significantly improved the results of laboratory parameters related to diet compliance in the intervention group compared to the results of the laboratory parameters before the intervention and the control group.

Influence Of Uncertainty, Depression, And Social Support On Self-Care Compliance In Hemodialysis Patients.

PurposeThis study was conducted to examine the associations among uncertainty, depression, social support, and self-care compliance in patients undergoing hemodialysis, and to identify the factors influencing self-care compliance.MethodsA convenience sample of 152 patients receiving hemodialysis was selected. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson correlations, and hierarchical regression analysis with the SPSS 23.0 program.ResultsParticipants performed a moderate level of self-care consisting of factors such as knowledge of hemodialysis, dietary knowledge of hemodialysis, dietary compliance with hemodialysis, and compliance with hemodialysis order. The self-care compliance of participants undergoing hemodialysis showed a significant relationship with depression, uncertainty, and social support. The factors significantly influencing self-care compliance were social support and occupation. These variables explained 24.9% of the variance in self-care compliance.ConclusionFindings from this study confirmed that uncertainty, depression, and social support are major factors affecting self-care compliance, and that the higher the patients’ uncertainty, the lower their self-care compliance. Thus, interventions should be performed to reduce uncertainty and to improve self-care through accurate information and education on disease progression and self-care.

REKOMENDASI MODEL PENINGKATAN KEPATUHAN PENGELOLAAN KESEHATAN PASIEN GAGAL GINJAL TERMINAL DI RSUD dr. H. MOH. ANWAR SUMENEP

Management of patients with end stage renal disease include physical therapy of the underlying disease, treatment of comorbid conditions, replace the renal function by renal replacement therapy. Compliance of health management on end stage renal diseases patients is required. Compliance consists of cognitive and psychomotor components. Cognitively, patient compliance involves understanding and ability to recall the information on medical advice. Compliance in hemodialysis patients affected by patient factors, health care systems and personel factor/provider.
 This study was observational design explanative aims to describe and analyzed the factors that affect the health management of compliance in patients with end stage renal disease. The population in this research was all patients with end stage renal disease who undergoing hemodialysis in the hemodialysis unit RSUD dr. H. Moh. Anwar Sumenep. Sampling technique used purposive sampling and obtained a sample of 32 patients in this study. Collecting data usedquestionnaires and was analyzed using partial least square (PLS). Measurement of inner model used to measure hypothesis with t statistic value > 1,96.
 The result showed that the t statistic value of patients factor was 1,989, health care system was 1,747 and provider factor was 2,933. The statistical result showed that factors of patient and personel factor/provider affected health management compliance.
 Improved health management compliance was required in patients with end stage renal disease, especially of patient factors required an understanding of the physical and psychological problems and patient motivation to comply. Enhanced compliance with health management approach based psychoeducation based on King interaction system will improve patient compliance of patients with end stage renal disease undergoing hemodialysis.

Nursing Intervention on the Compliance of Hemodialysis Patients with End-Stage Renal Disease: A Meta-Analysis

Background: Dialysis is imperative for patients with end-stage renal disease (ESRD); however, compliance ensures its efficacy. Nursing intervention has been considered to improve compliance. This meta-analysis is aimed at exploring the effects of nursing intervention on dialysis compliance. Methods: A search was performed in the PubMed, Cochrane, and Embase databases for relevant original research articles. Studies were included or excluded based on the simultaneous consideration of quality as ranked by Jadad score and the compliance with predefined selection criteria. Results: A total of 817 participants were included. The results showed that nursing intervention led to significantly higher compliance with dialysis than in standard care. A pilot analysis evidenced that different intervention strategies, including educational, cognitive, and behavioral approaches, had limited effects on dialysis compliance. Conclusion: Nursing intervention is beneficial for raising dialysis compliance, providing evidence of the need to strengthen nursing care for ESRD patients administered with dialysis in daily clinical practice.

A Structural Analysis for Psychosocial Variables related to Sick Role Behavioral Compliance in Hemodialysis Patients

A Structural Analysis for Psychosocial Variables related to Sick Role Behavioral Compliance in Hemodialysis Patients

Assessment Of Hemodialysis Patient's Compliance To The Treatment And Follow Up In Baghdad Teaching Hospitals

Objectives: The Study aims to identify the hemodialysis patients' compliance about the treatment and follow upin Baghdad Teaching Hospitals. Methodology: A descriptive study was conducted in five teaching hospitals in Baghdad City in 15/5/2012 to 15/8/ 2013 to achieve the objectives of the study, A non probability (purposive) sample of 200 cases which consists of patient with ESRD who are admitted to the dialysis centers at AL-Kadhmia, AL-Yarmok, AL-Kindey, AL-Karama, and Baghdad Teaching hospitals were selected, with their ages between 18 to less than 70 years old. And under hemodialysis treatment not less than 6 mouths. A questioner's format was used for data collection. The validity of questioner was estimated through a penal of experts related to the field of study, and its reliability was estimated through test/retest method which was estimated as average (r=0.89). Data was gathered by interview technique using the questionnaires format and data was analyzed by application of descriptive and inferential statistical By using SPSS version. Results: The results of the study indicated that (54.0%) of sample were males and most of them were range between (30-39) years old, (54%0) of them were single , while (28%) of them were married. Also the study indicated that (39%) of sample were housewife, (54 %) of them were under secondary school graduation, and (48%) of them the monthly income is not sufficient. Moreover the study indicated that (58%) of them had medical history less than five years in hemodialysis, and half of them done hemodialysis for three times per week, (75.5%) of them for four hours in each session. Conclusions: The results of the study indicated that most of them compliance to the treatment and not compliance to the follow up. Recommendation: The study recommends conducting and improving national programs of hemodialysis in Iraq, and the necessity of conducting other researchers in the field of Hemodialysis patients.

The Relationship Between Self-Efficacy and Fluid and Dietary Compliance in Hemodialysis Patients

Patients with end-stage renal disease (ESRD) require complex medical management that necessitates strict adherence to their treatment program. But why individuals are noncompliant with their prescribed therapeutic regimen is not well understood. The purpose of this study was to determine the relationship between self-efficacy and self-reported fluid and dietary compliance as well as identify the possible barriers that prevented patient compliance. One hundred ESRD patients who received hemodialysis three times a week participated. Bivariate correlational analysis showed there were strong positive correlations between self-efficacy and daily fluid (r = .56; p < .001) and dietary (r = .53; p < .001) restrictions. Linear regression analysis was used to analyze the potential barriers predicted for fluid and dietary compliance, which also showed statistical significance. The results showed those who reported being in social gatherings were less compliant with fluid and dietary restrictions (F[1, 90] = 14.62, p < .001). Similarly, those who reported greater frustration with kidney disease reported less compliance with fluid and dietary restrictions (F[1, 90] = 4.65, p < .01). By using the results of this study, clinicians and nurses can adopt multiple strategies to improve patient self-efficacy levels and self-management capacities. This study also provides a better understanding of barriers that prevents dietary and fluid restriction compliance.

Marital satisfaction and therapeutic regimen compliance in hemodialysis patients in hospitals of Shahid Beheshti University of Medical Sciences and Health Services in 1388- 89.

Abstract Backgrounds and aim Therapeutic regimen non compliance is a common problem in hemodialysis patients. It is associated with many side effects. Marital satisfaction and conflictions in dyadic relationships have an important effect on compliance of a complex regimen. This study aims to determine the correlation between marital satisfaction and therapeutic regimen compliance in hemodialysis patients in hospitals of Shahid Beheshti University of Medical Sciences and Health Services in 1388-89. Materials and Methods In this descriptive correlatiional study 100 hemodialysis patients were selected through the judgmental sampling method. Data gathering tool was a questionnaire consisting three parts: demographic data, disease and ENRICH Marital Satisfaction Inventory. The latter part is validated by content validity method. The reliability of ENRICH Marital Satisfaction Inventory was determined by Chronbach’s = method. The questionnaires were completed by patients during hemodialysis. In order to determine the compliance of therapeutic regimen, the researcher recorded the mean of the last three months’ values of P, K, interdialytic weight gain, and the numbers of missed dialysis sessions using patient’s documents. Data were analyzed by SPSS statistical software Findings While 56% of patients had compliance in therapeutic regimen. 59% had low and very low and 41 % of patients had moderate and high marital satisfaction. There was a significant correlation between marital satisfaction and therapeutic regimen compliance and marital satisfaction in patients with therapeutic regimen compliance was high. Conclusion Planning for counseling and supportive programs concerning marital satisfaction can be beneficial for patients and their families in order to increase their therapeutic regimen compliance. Keywords: Marital satisfaction, Compliance, Hemodialysis, Chronic renal failure

Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality

Patients receiving hemodialysis have high rates of cardiovascular morbidity and mortality that may be related to the hemodynamic effects of rapid ultrafiltration. Here we tested whether higher dialytic ultrafiltration rates are associated with greater all-cause and cardiovascular mortality, and hospitalization for cardiovascular disease. We used data from the Hemodialysis Study, an almost-7-year randomized clinical trial of 1846 patients receiving thrice-weekly chronic dialysis. The ultrafiltration rates were divided into three categories: up to 10 ml/h/kg, 10-13 ml/h/kg, and over 13 ml/h/kg. Compared to ultrafiltration rates in the lowest group, rates in the highest were significantly associated with increased all-cause and cardiovascular-related mortality with adjusted hazard ratios of 1.59 and 1.71, respectively. Overall, ultrafiltration rates between 10-13 ml/h/kg were not associated with all-cause or cardiovascular mortality; however, they were significantly associated among participants with congestive heart failure. Cubic spline interpolation suggested that the risk of all-cause and cardiovascular mortality began to increase at ultrafiltration rates over 10 ml/h/kg regardless of the status of congestive heart failure. Hence, higher ultrafiltration rates in hemodialysis patients are associated with a greater risk of all-cause and cardiovascular death.

Effect of home care nursing guidelines on hemodialysis patients compliance of ingesting liquid

Objective To observe the effect of home care nursing guidelines based on care protocol nursing theory on hemodialysis(HD)patient compliance of ingesting liquid.Methods Forty-eight HD cases were randomized into Groups A(the observation group,n = 24)and B(the control group,n = 24).The control group was given usual care and health education,and the observation group was additionally cared with home care nursing based on care protocol nursing theory for 1 month and followed up for 3 months.The compliance of ingesting liquid was evaluated and the relation between the family supporting and the IDGW relative magnitude (IDGW)was obversed.Results The IDGW relative magnitude of the observation group was lower than the control group;the compliance of ingesting liquid was more improved in the observation group;the level of family supporting of the observation group was obviously higher than the control group;and it was a negative correlation between the family supporting and the IDGW relative magnitude.Conclusions Home care nursing based on care protocol nursing theory makes patients get family support from their family that got guidelines,increase the compliance of ingesting liquid,and control IDGW during hemedialysis in an ideal range, Key words: Home care(non-professional); Renal dialysis; Drinking; Patient compliance; Body weight control

Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients

End-stage renal disease (ESRD) is a growing public health concern and non-adherence to treatment has been associated with poorer health outcomes in this population. Depression, likely to be the most common psychopathology in such patients, is associated with increased morbidity and mortality. We compared psychological measures and self-reported medication adherence of 94 kidney transplant recipients to those of 65 patients receiving hemodialysis in a major medical center in Brooklyn, New York. Compared to the transplant group, the hemodialysis cohort was significantly more depressed as determined by the Beck Depression Inventory score. They also had a significantly lower adherence to medication as reported on the Medication Therapy Adherence Scale. Using hierarchical multiple regression analysis, the variance in depression was the only statistically significant predictor of medication adherence beyond gender and mode of treatment, accounting for an additional 12% of the variance. Our study strongly suggests that a depressive affect is an important contributor to low medication adherence in patients with ESRD on hemodialysis or kidney transplant recipients.