End-Stage Renal Disease Adherence Questionnaire Research Articles

Adherence to Fluid Restrictions among Haemodialysis Patients In Private Haemodialysis Centres in Kuala Lumpur Malaysia

End stage kidney disease (ESKD) is an irreversible progressive kidney function that requires kidney replacement therapy. Over two million people have currently received dialysis treatment worldwide. Haemodialysis treatment has been developed as a practical, safe and efficient method for the care of patients with ESRD. However, HD treatments generally have a more negative impact on patients' quality of life (QoL), high morbidity and mortality rate, as well as major adverse cardiovascular events. Compliance to dietary, fluid restrictions, medications and treatment regimens is one of the contributors to the quality of life observed in patients ESKD undergoing haemodialysis treatment. This study is aimed on the measurement of the fluid restriction adherence of 132 haemodialysis patient in MAIWP-PICOMS haemodialysis centres. An interdialytic weight gain (IDWG) was used as an indicator to describe the level of adherence level. Method: An observational study was conducted among consenting patients on HD for ≥3 months with criteria of age from 18 to 65 years old using end-stage renal disease-adherence questionnaire (ESRD-AQ). Result: Of 132 participated patients were observed, 53% were female and 47% were male with a mean age of 49.05 ±11.52 years and HD duration mean length of 1.33 ranging from 1-5 years. Statistically, a significant association between level of fluid adherence behaviour and treatment duration (p < .01) was found in this study. Meanwhile, the level of adherence to fluid restrictions was range between 45.5% - 50%, which was considered good. Conclusion: Significantly, adhered to fluid restriction among haemodialysis patients may prevent patients from many adverse consequences and improve the quality of life. Therefore, nurses and healthcare providers has been suggested to play a pivotal role in delivering education on fluid restriction for haemodialysis patient.

#69 Validation of the Visayan Translation of the End Stage Renal Disease—Adherence Questionnaire (VESRD-AQ)

Abstract Background and aims End-stage renal disease (ESRD) is one of the chronic diseases that rely heavily on patient's adherence to treatment. Measuring the factors related to adherence have been done but are difficult to compare due to non-uniformity of the tools used. The 46-item End-Stage Renal Disease—Adherence Questionnaire (ESRD-AQ) by Kim, et.al (2010) is a validated tool used to measure treatment adherence to the whole of ESRD management: hemodialysis, medications, fluid restrictions, and diet prescription. About 2000 ESRD patients have been registered in the Central Visayas, Philippines in 2022. The availability of a standardized and validated tool in the Visayan native language will help in assessing adherence and its related factors which can lead to interventions that could improve outcomes in ESRD patients. This study was done to translate the End-stage renal disease (ESRD-AQ) into the Visayan dialect (Visayan ESRD-AQ) and test its validity. Method The ESRD-AQ underwent forward translation into a Visayan version. This translation was evaluated for content validity using the Content Validity Index (CVI) rated by 5 experts, and face validity with a group of 5 ESRD patients. Blind backward translation was done and compared to the original ESRD-AQ. Construct validity was tested via a Known-Group Analysis. Test-retest reliability was done using the Intraclass Correlation Coefficient (ICC) to establish the questionnaire's stability overtime. Results The Visayan ESRD-AQ had adequate Content Validity Index of 1.0 which shows that each item on the questionnaire was relevant to its aim. Construct validity showed that the known adherers had higher scores than the known non-adherers. This means that the questionnaire was able to differentiate between the two groups. The responses of two patients were evaluated through the Intraclass Correlation Coefficient (ICC) and had the scores of 0.52 and 0.69, meaning that the questionnaire can be reliably used over time. Conclusion The Visayan ESRD-AQ is a valid and reliable tool for measuring adherence behaviors in a sample of Visayan-speaking dialysis patients as supported by the results of the Content Validity Index and known-group analysis. The can also be used reliably over time as it showed moderate test- retest reliability score. The validated VESRD-AQ may be valuable to researchers in studies of advanced chronic kidney disease. It could be used for studying adherence behaviors of ESRD patients across the Visayan region of the Philippines and the factors that contribute to adherence or non-adherence. Results of these studies can be used to improve services in dialysis units and can even be a tool in policy making with regards to hemodialysis in the Philippines. Further translations into other dialects or languages can also be done to be able to reach a broader population.

Adherence to treatment in patients with chronic kidney disease undergoing hemodialysis

Objective: To identify the adherence to therapeutic regimens in patients with chronic kidney disease undergoing hemodialysis (HD). Method: This is a descriptive, cross-sectional study using a quantitative approach developed at an HD center in the south of Minas Gerais, Brazil. The study participants were 51 patients undergoing HD. Personal, socioeconomic, and objective data were collected, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) was applied. The analysis was performed using simple descriptive statistics. Result: The average age was 56.7 years, and 58% of the patients were male. The percentages of non-adherence were diet (35.4%), hemodialysis (21.6%), fluid intake (15.7%), and medication (13.7%). Conclusion: Therapeutic adherence is a complex process that requires constant monitoring by a multidisciplinary team.

The impact of teach-back training method (TBTM) on treatment adherence in hemodialysis patients: a randomized controlled trial.

Ensuring adherence to treatment is vital for individuals undergoing haemodialysis. The demanding treatment frequency and duration often present challenges for patients in maintaining a consistent routine. Non-adherence can result in adverse health effects and an increased risk of hospitalization. This study aimed to evaluate the impact of teach-back training on treatment adherence among haemodialysis patients. A randomized controlled trial involved 60 end-stage kidney disease patients undergoing haemodialysis. Participants were randomly assigned to either the control or intervention group. Data were collected using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), assessing adherence in four dimensions: HD incidence, medication use, fluid restriction, and diet recommendations. The intervention group received feedback-based training on diet and fluid restriction during four 45-60-min sessions, while the control group received regular indoor training. Following the intervention, significant differences in mean scores for HD frequency, medication use, and fluid restriction were observed between the two groups (P<0.001). However, there was no significant difference in the mean score for food recommendations (P=0.108). The teach-back training method (TBTM) is an effective communication strategy that enhances treatment adherence in haemodialysis patients. This intervention has the potential to improve patient outcomes and overall quality of life by simplifying medical information and encouraging patient engagement.

DIETARY ADHERENCE COMPONENT OF END-STAGE RENAL DISEASE ADHERENCE QUESTIONNAIRE (ESRD-AQ): TRANSLATION AND VALIDATION

Introduction: A nutritionally balanced diet is crucial among end-stage renal disease (ESRD) patients to maintain their health status. An appropriate instrument is needed to assess ESRD patients’ adherence towards dietary recommendations. Several questionnaires to measure adherence behaviours of ESRD patients are available but none has ever been translated into the Malay language. Therefore, this study aimed to translate the End-stage Renal Disease Adherence Questionnaire (ESRD-AQ), focusing on the dietary adherence component, from English to Malay. Methodology: Forward and backward translations of the questionnaire were done involving experts in dietetics and linguistics to produce a pre-harmonized Malay translation and two backward English translations according to established guidelines. An expert committee reviewed these translated questionnaires to produce a harmonized version. This then underwent a pre-test and cognitive interview, as well as face validity assessment, involving 15 hemodialysis patients. The Cronbach’s alpha was also analyzed to assess the internal consistency of the questionnaire. Results: Minor amendments were made to several phrases during the expert committee review to ensure the translated questionnaire was contextually appropriate and culturally adapted in Malay language. All questions in the Malay version of ESRD-AQ achieved a Face Validity Index (FVI) value of 1.00, indicating high validity. Additionally, the questionnaire produced a Cronbach's alpha value of 0.84, which is within the acceptable range. Conclusion: The Malay version of ESRD-AQ (Dietary Adherence Component) underwent translation and validation protocols, the findings of which indicate that it is clear, comprehensible, and reliable for use in assessing dietary adherence among ESRD patients in Malaysia.

Adherence of Hemodialysis Patients to Fluid, Diet, Medications, and Hemodialysis Sessions, Makkah, Saudi Arabia.

The adherence of hemodialysis (HD) patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. Despite its importance, there is a remarkable paucity in research dealing with the adherence of patients under HD in Saudi Arabia. The objective of this study was to identify the prevalence of adherence to fluid, diet, medications, and HD sessions among HD patients in Makkah. This was a cross-sectional study in which 361 HD patients were randomly selected from HD centers in three governmental hospitals in Makkah. Individuals were assessed for adherence using the End-Stage Renal Disease Adherence Questionnaire in addition to a clinical examination and laboratory investigations. These methods were used to identify the level of adherence to fluid, diet, medications, and HD sessions. The frequency of adherence of patients was found to be high for dietary guidelines (88.4%), fluid restriction (87.8%), and medications (88.0%), but it was relatively low for adherence to HD sessions (56.0%). The overall adherence rates in the current study population were thought to be within the range of most published international studies.

The need for standardised outcomes in pharmacist interventions in chronic kidney disease: a systematic review of randomised controlled trials

Abstract Introduction People living with chronic kidney disease (CKD) have a high prevalence of polypharmacy. Polypharmacy presents a significant burden and the risk of inappropriate prescribing in people with CKD is a cause for concern due to age-related changes associated with pharmacodynamics (e.g., increased sensitivity towards adverse drug events) and pharmacokinetics (e.g., reduced renal excretion)1. Strategies for the successful management of CKD include controlling cardiovascular risk factors, lifestyle modifications, and treating comorbidities. There is an ever-increasing role of pharmacists in managing CKD, from medication reviews to optimising risk factors2. However, currently, there is a lack of quality data on the impact of pharmacists in CKD management; this is partly due to the wide range of variable outcomes used in studies and a lack of standardised outcome reporting. Aim We aimed to explore the range of outcomes and measures used in pharmacist-led research in CKD that could be recommended for standardised use. Methods A systematic review of randomised controlled trials (RCTs) of interventions in a CKD population with significant pharmacist input was conducted. Searches were conducted in the following databases: MEDLINE, Scopus, and Web of Science. Databases were searched until January 2022; searches were re-run in February 2023. Data was extracted pertaining to clinical (e.g., mortality), economic (e.g., healthcare-associated costs), and humanistic (e.g., quality of life (QoL)) outcomes. Ethical approval was not required because this review is based exclusively on published literature. Results 38 reports of 32 RCTs were identified, with sample sizes of RCTs ranging from 24 to 32,917 participants. Most studies were conducted in the United States (16/32), whilst one was conducted in the United Kingdom. Of these, 12/32 (37.5%) were exclusively conducted in people on dialysis, six in kidney transplant recipients, 13 in those with non-dialysis dependent CKD, and one study in a mixed cohort. The interventions delivered by pharmacists were heterogenous and included medicine reconciliation, patient counselling, and dose adjustment. A wide range of outcomes were reported including blood pressure, CKD progression, and QoL. The most frequently reported outcome was blood pressure, which was used as an endpoint in 12/32 (37.5%) studies. There was significant heterogeneity in the measures and methods used for reported outcomes. For example, in 11/32 studies (34.4%) where medication adherence was assessed, five separate outcome measures were used: variations of the Morisky Medication Scale (6/11), pharmacy refill records (2/11), Basel Assessment of Adherence to Immunosuppressive Medication Scale (1/11), a comparison of the quantity of medications prescribed with those present in containers (1/11), and the endstage renal disease adherence questionnaire (1/11). Discussion/Conclusion Nephrology is well adept in the use of standardised core outcome sets (COS) (e.g., the Standardised Outcomes in Nephrology initiative)3, yet such COS may not be appropriate to more specialist interventions where different or more relevant outcomes may be needed. The plethora of outcome measures identified in our review suggests a better standardisation of reporting is needed to facilitate consolidation of pharmacy research in the area and further support for the role of the pharmacist in CKD management.

Structural Equation Modeling of Treatment Adherence Based on General Health and Demographic Characteristics in Patients Undergoing Hemodialysis

Background: A complete adherence to treatment is essential for patients undergoing hemodialysis treatment. This health behavior is the product of various overlapping variables that may change over time. Objectives: This study aimed to investigate treatment adherence based on general health and demographic characteristics among hemodialysis patients. Methods: This was a descriptive-correlation research conducted based on structural equation modeling. The population included all patients with chronic kidney disease in Tehran, Iran, of whom 200 patients undergoing hemodialysis admitted to 2 medical centers from September to March 2022 were selected by convenience sampling. The data were collected using the General Health Questionnaire (GHQ) and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). The data were analyzed using correlation analysis and path analysis in SPSS v. 19 and SmartPLS v. 3. Results: The results showed the direct and significant effect of general health (P = 0.001) and age (P = 0.017) on treatment adherence. However, sex, marital status, level of education, and duration of dialysis treatment had no significant effect on treatment adherence. Conclusions: Considering the power of general health and age in predicting treatment adherence, these two variables can be included in training, clinical, and psychological interventions.

Exploring the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD).

The aim of this study is to investigate the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD). A cross-sectional study was conducted among patients with CAPD at the Department of Nephrology, Lianshui People's Hospital from October 2021 to May 2022. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and the End-Stage Renal Disease Adherence Questionnaire was used to evaluate treatment compliance. Quality of life was assessed using the SF-36 questionnaire. Scores from all the questionnaires and demographic data were recorded. A total of 98 patients were enrolled, and the prevalence of cognitive impairment among CAPD patients was 69.39% (MoCA score < 26). Patients were divided into 2 groups: one group with normal cognitive function (MoCA score ≥ 26) and the other with cognitive impairments. There were statistically significant differences in age, dialysis age, education, urea clearance index, history of high blood pressure, and diabetes between the 2 groups (all P < .05). Patients with cognitive impairments had lower compliance levels in terms of diet fluid restriction, medication therapeutic regimens, and dialysis regimen (all P < .05). Patients with cognitive impairments also had lower quality of life scores in the dimensions of physical function, general health, social function, emotional function, and mental health (all P < .05). Cognitive impairment appears to be common among CAPD patients and may adversely affect both their treatment adherence and overall quality of life. A more comprehensive understanding of the underlying mechanisms necessitates further study.

Psychometric properties of End Stage Renal Disease-Adherence Questionnaire-Sinhalese version among patients receiving haemodialysis.

The chronic kidney disease is a leading public health concern, particularly in low-to middle-income countries, while the number of patients receiving haemodialysis is rapidly increasing. Adherence to a complex treatment regimen is vital for those patients on maintenance haemodialysis though the precise evaluation is reported inadequately. This study aimed to evaluate the psychometric properties of Sinhalese version of End Stage Renal Disease-Adherence Questionnaire (SINESRD-AQ) to assess treatment adherence behaviour among patients receiving haemodialysis in a Sri Lankan hospital. The cultural adaptation of ESRD-AQ involved forward and back translation, expert committee consolidation and pretesting among patients (n = 10). Face and content validity of the questionnaire was evaluated using a modified Delphi technique. Construct validity of the subscales of SINESRD-AQ was evaluated using confirmatory factor analysis (CFA). A descriptive cross-sectional study among a consecutive sample of 150 patients receiving haemodialysis in a selected Teaching hospital, Sri Lanka was involved in performing CFA. Reliability was confirmed with test-retest reliability. Excellent face and content validity were reported with Item level content validity index (0.83-1.0), Average Item level content validity index for whole scale (0.93), Item level content validity ratio (0.67-1.0) and modified kappa statistic coefficient (0.81-1.0). CFA of two subscales demonstrated better indices closure to the model fit with five- item two factor model for direct adherence behaviour subscale and eight-item two factor model for attitude/perception subscale. The intra class correlation coefficient of 0.837 (p<0.001) and 0.752 (p<0.001) indicated acceptable test-retest reliability of direct adherence behaviour and attitude/perception subscale respectively. The study confirmed SINESRD-AQ as a valid and reliable measure which enables periodic assessment of treatment adherence behaviour of the patients receiving haemodialysis in a Sri Lankan hospital.

Evaluation of the Effect of Group Hope Therapy on Reducing Anxiety and Adherence to Treatment in Hemodialysis Patients

Background: Anxiety and non-compliance with treatment endanger the health of hemodialysis patients. Hope therapy focuses on human abilities and capabilities instead of weaknesses using a positive psychology approach. Objectives: This study aimed to evaluate the effect of group hope therapy (GHT) on reducing anxiety and adherence to treatment (ATT) in hemodialysis patients. Methods: This semi-experimental study was conducted with a pre-test and post-test on 40 patients undergoing hemodialysis as consecutive non-probability sampling from among the clients of two hemodialysis centers in Khorram Abad, Iran, in 2017. Primary data of the study was collected using the Spielberger State-Trait Anxiety Inventory (STAI) and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) in four stages, including before the intervention, immediately after the intervention, one and three months after the intervention. Hope therapy intervention was implemented in groups of five people for eight sessions (one session per week and each session for 60 minutes) by the researcher and with the supervision and approval of a psychiatrist and a clinical psychologist. The data were analyzed in the SPSS software version 21 at the significance level (α = 0.05). In addition, Cronbach’s alpha test was used to measure the reliability of the questionnaires. Results: There was a significant difference in the mean scores of anxiety and ATT between the two stages “before the intervention" and “immediately after the intervention" (P &lt; 0.05). In addition, there was no significant compliance with the treatment between the two stages “immediately after the intervention" and “three months after the intervention" (P &lt; 0.05), while the average scores of Overt and covert anxiety were significant (P &lt; 0.05). Conclusions: Based on the results, GHT effectively reduces overt and hidden anxiety and increases ATT in hemodialysis patients. Therefore, these results can help plan care for hemodialysis patients. Counseling sessions related to GHT should be offered for consecutive periods in educational and treatment centers by people with experience and training in working with hemodialysis patients.

Effect of mHealth Training on Treatment Adherence in Hemodialysis Patients

Background: Technological advancements and ease of communicating with and educating patients with kidney failure using various technologies have facilitated the achievement of treatment goals. Objectives: The present study aimed to examine the effect of mHealth training on treatment adherence in hemodialysis patients in Zahedan. Methods: This quasi-experimental study was conducted on 80 hemodialysis patients admitted to teaching hospitals in Zahedan in 2022. The participants were selected using convenience sampling and were divided into two intervention and control groups by allocation with permutation blocks. In addition to routine training, the participants in the intervention group received mHealth training in five areas of treatment adherence using a smartphone application (My Dialysis) developed by the researcher. The participants in the control group received only routine training. The data were collected by a demographic information form, the Media Literacy Questionnaire, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) in both groups before and three months after the intervention. The collected data were analyzed with SPSS (version 26) using the paired and independent samples t-test, chi-square test, and analysis of covariance (ANCOVA) at the significance level of less than 0.05 (P &lt; 0.05). Results: The mean treatment adherence score for the patients in the control group increased from 1011.87 ± 150.96 before the intervention to 1110.62 ± 86.95 after the intervention, showing a significant increase (P &lt; 0.001). Besides, the mean treatment adherence score for the patients in the intervention group increased significantly from 1067.50 ± 122.24 before the intervention to 1161.25 ± 49.98 after the intervention (P &gt; 0.001). The results of ANCOVA to control for the significant effect of the pretest scores and the disease duration showed that the patients' mean treatment adherence scores in the two groups significantly differed after the intervention (P &lt; 0.05). Conclusions: This study confirmed the significant positive effects of mHealth training on the treatment adherence of dialysis patients. Thus, considering the effectiveness of routine training, mHealth training can be used with routine training in treatment programs for hemodialysis patients to improve their treatment adherence.

The relationship between hemodialysis patients' treatment adherence, procrastination, and difficulty in emotion regulation: A cross-sectional study in southeast Iran.

End-stage renal disease is a life-threatening condition in which patients require dialysis or kidney transplant. These patients must adhere to the treatment regimen because treatment non-adherence affects their quality of life and health. We conducted this study to predict hemodialysis patients' treatment adherence based on procrastination and difficulty in emotion regulation. We conducted this descriptive correlational study on 218 hemodialysis patients with chronic kidney disease. We used purposive sampling to select participants from six dialysis centers in Kerman, Sirjan, and Rafsanjan. The measuring tools included the end-stage renal disease adherence questionnaire, general procrastination scale, decisional procrastination scale, and difficulty in emotion regulation scale. We used the correlation coefficient, regression analysis, and SPSS18 to analyze data. Our study indicated that among the dimensions of treatment adherence, medication use had a significant, weak, and inverse relationship with general and decisional procrastination. We also found a significant, weak, and inverse relationship between attendance and general procrastination (p < 0.05 and p < 0.01). But there is no significant relationship between treatment adherence, general procrastination, and decisional procrastination (p > 0.05). Multivariate regression analysis revealed a relationship between age, the cause of kidney failure, and treatment adherence (p = 0.01 and p = 0.02). Treatment non-adherence causes problems and complications in hemodialysis Patients, and disrupts their course of treatment. Therefore, it is necessary to identify the factors influencing non-adherence of patients undergoing hemodialysis and improve their treatment adherence, and thus their quality of life.

The effect of positive thinking training on hope and adherence to treatment in hemodialysis patients: a randomized controlled trial

BackgroundPatients undergoing hemodialysis are exposed to psychological problems, such as despair, which in turn can be a trigger for them to abandon the treatment process. This study aimed to determine the effect of positive thinking training on hope and adherence to treatment in hemodialysis patients.MethodsThis randomized controlled trial was performed on 80 hemodialysis patients referred to two hemodialysis centers in Shiraz, Iran. They were randomly divided into an intervention and a control group. Eight sessions of positive thinking skills training carried out individually on the patients' bedsides. The primary and secondary outcomes were hope and adherence to treatment, respectively. The data were collected using Snyder Hope Questionnaire, End-Stage Renal Disease Adherence Questionnaire, laboratory tests, and weight measurements. Data were analyzed by Chi-square and Paired and Independent T-test using SPSS software version 18.ResultsAfter the intervention, the mean score of hope was significantly higher in the intervention group (42.1 ± 6.1) than in the control group (38.7 ± 6.5) (p = 0.024). Moreover, after the intervention, the mean score of adherence to treatment was significantly higher in the intervention group (1070.2 ± 80.1) compared to the control group (1018.4 ± 105.3) (p = 0.019). In addition, blood urea nitrogen, phosphate and inter-dialytic weight gain were lower in the intervention group compared to the control group after the intervention.ConclusionsThe findings showed that positive thinking interventions could lead to improvement in hope and adherence to treatment in hemodialysis patients. Positive thinking training could be used in caring of hemodialysis patients to improve their hope and adherence to treatment.Trial registration RCT Registry: Iranian Registry of Clinical Trials; RCT registration number: IRCT20180915041044N1; Registration date: 19/12/2018.

Hubungan Kepatuhan Menjalani Terapi Hemodialisis dengan Kualitas Hidup Pasien Penyakit Ginjal Kronik di Masa Pandemi Covid-19

Introduction : The COVID-19 pandemic became one of the highest causes of death in early 2020. The spread is so fast and uncontrollable that it is the reason for many people to stay at home and avoid places with the highest spread, one of which is the hospital. In this condition, many people delay treatment, choose alternatives, and decide to no longer be in the hospital environment. This also applies to patients with chronic kidney failure, where sufferers are required to continue to take therapy to achieve a good quality of life. However, with the COVID-19 situation, most sufferers postpone therapy so they don't get infected. Compliance with therapy is very important for people with CKD to be able to achieve a good quality of life. This study aims to determine the relationship between compliance with hemodialysis therapy and the quality of life of CKD patients undergoing hemodialysis therapy during the COVID-19 period. Method: The research design used is descriptive correlational with a cross sectional approach. The sample in this study was a total sampling of 70 respondents. This study used the KDQL questionnaire to measure quality of life and The End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) questionnaire to measure adherence. The analysis used was bivariate analysis using the chi-square test. Results: Iit was found that 71.4% adhered to hemodialysis therapy and, 54.3% have a good quality of life. The statistical test results showed that there was a significant relationship between adherence to hemodialysis therapy and the quality of life of CKD patients where the p-value was 0.026 &lt; α (0.05). Conclusion: There is a significant relationship between adherence and quality of life of CKD patients undergoing hemodialysis therapy. Nurses have an important role in motivating CKD patients to comply with hemodialysis therapy.Keywords: Hemodialysis Therapy, Adherence, Quality of Life, Chronic Kidney Disease.

Hubungan Kepatuhan Menjalani Terapi Hemodialisis dengan Kualitas Hidup Pasien Penyakit Ginjal Kronik di Masa Pandemi Covid-19

Introduction : The COVID-19 pandemic became one of the highest causes of death in early 2020. The spread is so fast and uncontrollable that it is the reason for many people to stay at home and avoid places with the highest spread, one of which is the hospital. In this condition, many people delay treatment, choose alternatives, and decide to no longer be in the hospital environment. This also applies to patients with chronic kidney failure, where sufferers are required to continue to take therapy to achieve a good quality of life. However, with the COVID-19 situation, most sufferers postpone therapy so they don't get infected. Compliance with therapy is very important for people with CKD to be able to achieve a good quality of life. This study aims to determine the relationship between compliance with hemodialysis therapy and the quality of life of CKD patients undergoing hemodialysis therapy during the COVID-19 period. Method: The research design used is descriptive correlational with a cross sectional approach. The sample in this study was a total sampling of 70 respondents. This study used the KDQL questionnaire to measure quality of life and The End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) questionnaire to measure adherence. The analysis used was bivariate analysis using the chi-square test. Results: Iit was found that 71.4% adhered to hemodialysis therapy and, 54.3% have a good quality of life. The statistical test results showed that there was a significant relationship between adherence to hemodialysis therapy and the quality of life of CKD patients where the p-value was 0.026 &lt; α (0.05). Conclusion: There is a significant relationship between adherence and quality of life of CKD patients undergoing hemodialysis therapy. Nurses have an important role in motivating CKD patients to comply with hemodialysis therapy.Keywords: Hemodialysis Therapy, Adherence, Quality of Life, Chronic Kidney Disease.

Establishing the criterion validity of self-report measures of adherence in hemodialysis through associations with clinical biomarkers: A systematic review and meta-analysis.

Accurate measurement of adherence is crucial to rigorously evaluate interventions aimed at improving this outcome in patients undergoing in-center hemodialysis. Previous research has shown great variability in non-adherence rates between studies, mainly due to the use of different direct (e.g., clinical biomarkers) and indirect (e.g., questionnaires) measures. Although self-reported adherence in hemodialysis has been widely explored, it is still unclear which is the most accurate questionnaire to assess this outcome; therefore, the question of how to optimize adherence measurement in research and clinical practice has emerged as a key issue that needs to be addressed. This systematic review and meta-analysis aimed to explore the criterion validity of self-report measures of adherence in hemodialysis established through the association between test scores and clinical biomarkers (the criterion measure). The protocol was registered in PROSPERO (2021 CRD42021267550). The last search was performed on March 29th, 2022, on Web of Science (all databases included), Scopus, CINHAL, APA PsycInfo, and MEDLINE/PubMed. Twenty-nine primary studies were included, and thirty-eight associations were analyzed. The Hunter-Schmidt’s meta-analysis was computed for the associations with more than two studies (n = 20). The results showed that six associations were large (16%), 11 were medium (29%) and the remaining were of small strength. The test scores from the End-Stage Renal Disease Adherence Questionnaire (range: 0.212<rc <0.319) and the Dialysis Diet and Fluid Non-Adherence Questionnaire (range: 0.206<rc <0.359) had medium to large strength associations with interdialytic weight gain, serum phosphorus, and potassium levels, indicating that these questionnaires have reasonable concurrent criterion validity to measure fluid control and adherence to dietary restrictions in patients receiving hemodialysis. The available data did not allow exploring the criterion validity of the test scores in relation to hemodialysis attendance (skipping and/or shortening sessions). These results suggest that the decision to use one questionnaire over another must be made with caution, as researchers need to consider the characteristics of the sample and the objectives of the study. Given that direct and indirect methods have their advantages and disadvantages, the combination of adherence measures in hemodialysis is recommended to accurately assess this complex and multidimensional outcome.

THE RELATIONSHIP BETWEEN FEAR OF COVID-19 AND ADHERENCE FOR PEOPLE WITH END STAGE RENAL DISEASES WITH HEMODIALYSIS

Patients with End-Stage Renal Disease (ESRD) are highly vulnerable with the multiple comorbidities that make them susceptible to adverse outcomes with COVID-19. Over 2 million people worldwide receive maintenance hemodialysis (HD) at outpatient centers. In Indonesia, people have to come to dialysis centre at hospital for maintenance dialysis although in pandemic. Governments have been trying to fight the outbreak, by enacting various restrictions to maintain social distancing and effectively preventing the spread of infection among HD centre, healthcare personnel, and patients is essential to ensure the continued delivery of dialysis to ESRD patients but this condition affect in mental health people with hemodialysis such as fear of covid-19. The present study aimed to understand the relationship between fear of covid-19 and adherence people with hemodialysis to maintaining hemodialysis at hospital. The study group of the research consisted of 60 patients with hemodialysis were selected by the purposive sampling method. The research method is the correlational survey model. Data was obtained using the Demographic Information Form, fear of covid-19 scale and The End Stage Renal Disease Adherence Questionnaire (ESRD-AQ). Group comparison analysis revealed that women experienced higher levels of fear of the coronavirus. While those with postgraduate education reported significantly lower levels of fear of the coronavirus than those with other education levels. Fear of the coronavirus did not differ according to the age range, income level, and marital status of the participants. According to the results of the correlation analysis, a positive correlation between the fear of coronavirus and adherence people with hemodialysis to take medication at hospital was found.

Adherence to Different Treatment Modalities among Patients on Maintenance Hemodialysis

End Stage Renal Disease is a well-known global public health problem. Maintenance hemodialysis is considered a life-saving treatment for patients with such disease. This treatment method that requires patients to be adherent to hemodialysis attendance, dietary and fluid recommendations as well as adherence to prescribed medications to ensure success. The aim of the current study was to assess adherence, perception, and counseling among hemodialysis patients to different modalities of treatment (fluid restriction, dietary recommendations, medications, and hemodialysis schedules). A cross-sectional study carried out on hemodialysis patients who attended to the dialysis centers at al- Karama teaching hospital and Madinat Al- Imamain Al- Kadhimain teaching hospital. The Arabic version of the “ end stage renal disease-adherence questionnaire ” was used in assessing adherence, perception, and counseling. The number of recruited patients were 200 adult patients (113 men and 87 women). The average of the total adherence score lies within the moderate adherence (984.9 ±174.2). Patients adherence to the hemodialysis session was good as representing by high scores of adherence for (hemodialysis-attendance, episode of hemodialysis-shortening and duration of hemodialysis-shortening) while the lowest adherence score (126.0 out of 200) was for following the fluid restriction. In terms of adherence categories, the majority (61%) of the patients had good adherence, 33.0% had moderate adherence with 6% had poor adherence. Age had significant positive association with the total adherence score. All patients perceived their hemodialysis management as highly/very important. On the other hand, some patients perceived their adherence to the recommended diet as moderately (7%) or less important (7%). Regarding the frequency of counseling received by patients for different treatment modalities. The negative answers represented 58.5% of answers about the how important is to follow a proper diet, and 25.0% of answers about the importance of taking prescribed medications as ordered. Accordingly, the overall adherence of hemodialysis patients to different treatment modalities was less than optimum with fluid and diet adherence representing most challenging tasks in the health care of hemodialysis patients.

Adherence to Treatment among Patients With End-Stage Renal Disease Undergoing Hemodialysis In Selected Centers In Nepal.

Hemodialysis remains a commonly available treatment option for many patients with end-stage renal disease. In addition to regular hemodialysis, these patients require regular use of medicines, follow fluid restriction and dietary modification. Hence, adherence to treatment remains a major factor to improve survival and quality of life among these patients. Therefore, this study was carried out to identify the adherence to treatment among patients undergoing hemodialysis. A cross-sectional study was conducted among 160 patients undergoing hemodialysis at three centers of Bagmati province of Nepal from July to December 2020. We used End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) to record the adherence scores in different domains of treatment adherence. The scores were compared with different sociodemographic variables using nonparametric tests. Out of a total score of 1200, the overall obtained mean score was 1084.07±125.58. The percentage of the respondents adhering to dialysis, medicines, fluid, and diet was 91.9%, 76.3%, 48.9%, and 43.0% respectively. Male patients scored significantly higher score in the diet. And the married patients scored higher in adherence to fluid. Patients with middle socio-economic status scored significantly higher score in adherence to hemodialysis treatment. More than half of the respondents were non adherent to fluid and diet. Periodic motivation by health care professional and dietary counseling by dietitians might be helpful to improve the adherence to treatment.