Psychosocial factors affecting the adherence of chronic kidney disease patients to undergo a hemodialysis program: a cross-sectional study
Downloads
Introduction: This study aims to analyze the effect of psychosocial factors on hemodialysis program adherence.
Methods: The study was cross-sectional, with a sample size of 90 respondents, obtained through simple random sampling. The study’s dependent variable was hemodialysis program adherence and the independent variables were knowledge, motivation, coping, depression, perceived family support and health worker support. Data were collected using a questionnaire and analyzed using multiple linear regression.
Results: Most respondents adhered to the hemodialysis program (90%). The level of knowledge, motivation, coping, family support, and health worker support was in the good category (93.3%; 100%; 91.1%; 90%; 88.9%, respectively), and did not experience depression (90%). The independent variables (knowledge, motivation, coping, family support, health worker support) simultaneously significantly affected the dependent variable, namely adherence to the hemodialysis program by 94.5% (R2 = 0.945; F = 236.613; p = 0.001). Partially, the factors of knowledge, motivation, coping, family support, health workers support, and depression also had a significant effect on hemodialysis program adherence (t = 2.234, t = 5.344, t = 3.473, t = -4.190, t = 6.457, t = 4.887, t = 4.190, respectively; p = 0.001).
Conclusions: The study results showed that psychosocial factors (knowledge, motivation, coping, family support, health worker support, and depression) simultaneously or partially influenced the adherence of CKD patients to undergo a hemodialysis program, with the most dominant factor affecting adherence to hemodialysis as perceived family support.
Keywords: Adherence, Hemodialysis, Psychosocial
Agu, K. D. and Tambunan, E. H. (2024) ‘The relationship between motivation and adherence in patients with chronic kidney disease in undergoing hemodialysis therapy in the hospital’, Nutrix Journal, 8(1), pp. 131–139. doi: 10.37771/nj.v8i1.1095.
Alhamad, M. A. et al. (2023) ‘Factors affecting adherence to hemodialysis therapy among patients with end-stage renal disease attending In-Center Hemodialysis in Al-Ahsa Region, Saudi Arabia’, Cureus, 15(10), pp. 1–11. doi: 10.7759/cureus.46701.
Alikari, V. et al. (2017) ‘A modified version of the Greek Simplified Medication Adherence Questionnaire for hemodialysis patients’, Health Psychology Research, 5(1), pp. 1–7. doi: 10.4081/hpr.2017.6647.
Alikari, V. et al. (2019) ‘The impact of education on knowledge, adherence and quality of life among patients on haemodialysis’, Quality of Life Research, 28(1), pp. 73–83. doi: 10.1007/s11136-018-1989-y.
Alisa, F. and Wulandari, C. (2019) ‘Factors associated with compliance in chronic kidney disease (CKD) patients undergoing hemodialysis at RSIP Dr. M. Djamil Padang’, Jurnal Kesehatan Mercusuar, 2(2), pp. 58–71. doi: 10.36984/jkm.v2i2.63.
Alzahrani, A. M. A. and Al-Khattabi, G. H. (2021) ‘Factors influencing adherence to hemodialysis sessions among patients with end-stage renal disease in Makkah City’, Saudi Journal of Kidney Diseases and Transplantation, 32(3), pp. 763–773. doi: 10.4103/1319-2442.336772.
Al atawi, A. A. and Alaamri, M. M. (2021) ‘The relationship between perceived social support and adherence to treatment regimens among patients undergoing hemodialysis: A scoping review’, Evidence-Based Nursing Research, 4(1), pp. 1–17. doi: 10.47104/ebnrojs3.v4i1.231.
Cardol, C. K. et al. (2022) ‘Psychosocial barriers and facilitators for adherence to a healthy lifestyle among patients with chronic kidney disease: A focus group study’, BMC Nephrology, 23(1), pp. 1–16. doi: 10.1186/s12882-022-02837-0.
Dsouza, B. et al. (2023) ‘Effect of educational intervention on knowledge and level of adherence among hemodialysis patients: A randomized controlled trial’, Global Health, Epidemiology and Genomics, 2023(4295613), pp. 1–9. doi: 10.1155/2023/4295613.
Fotaraki, Z.-M. et al. (2022) ‘Depression, adherence, and functionality in patients undergoing hemodialysis’, Cureus, 14(2), pp. 1–12. doi: 10.7759/cureus.21872.
Gebrie, M. H. et al. (2023) ‘Patients’ experience of undergoing maintenance hemodialysis: An interview study from Ethiopia’, PLoS ONE, 18(5), p. e0284422. doi: 10.1371/journal.pone.0284422.
González-Flores, C. J. et al. (2021) ‘Resilience: A protective factor from depression and anxiety in mexican dialysis patients’, International Journal of Environmental Research and Public Health, 18(22), pp. 1–12. doi: 10.3390/ijerph182211957.
Hamby, S., Grych, J. H. and Banyard, V. (2015) Coping Scale, TN: Life Paths Research Program. doi: 10.13140/RG.2.1.3094.0001.
Al Husna, C. H., Yetti, K. and Sukmarini, L. (2019) ‘Determinant of fluid adherence among hemodialysis patients in Malang, Indonesia’, Enfermeria Clinica, 29(S2), pp. 117–122. doi: 10.1016/j.enfcli.2019.04.018.
Hwang, H. C. et al. (2018) ‘Influence of major coping strategies on treatment non-adherence and severity of comorbid conditions in hemodialysis patients’, Journal of Korean Medical Science, 33(20), pp. 1–11. doi: 10.3346/jkms.2018.33.e148.
International Society of Nephrology (2023) ISN-Global Kidney Health Atlas 2023, ISN: Internacional Society of Nephrology. Brussels.
Isdiarti, R. and Ardian, I. (2020) ‘Correlation of family support with quality of life of patient chronic renal failure undergo hemodialysis’, Jurnal Ners, 15(Special Issue), pp. 569–573. doi: 10.20473/jn.v15i1Sp.22127.
Jemali, C. M., Munyua, J. and Atoni, R. (2023) ‘Effect of depression on level of compliance with hemodialysis among chronic kidney disease patients at Moi Teaching and Referral Hospital, Kenya’, Hybrid Journal of Psychology, 4(1), pp. 30–42. doi: 10.58256/hjp.v4i1.1296.
Kerr, M. et al. (2024) ‘Experiences of indigenous patients receiving dialysis: Systematic review of qualitative studies’, American Journal of Kidney Diseases, 83(2), pp. 139-150.e1. doi: 10.1053/j.ajkd.2023.07.014.
Mailani, F. et al. (2024) ‘Good health literacy leads to better quality of life and medication adherence among hemodialysis patients’, Jurnal Ners, 19(1), pp. 101–109. doi: 10.20473/jn.v19i1.49247.
Mehrotra, R. et al. (2023) ‘Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference’, Kidney International, 104(3), pp. 441–454. doi: 10.1016/j.kint.2023.05.019.
Melastuti, E. et al. (2022) ‘Self-care adherence in hemodialysis patients: A structural equation modeling’, Open Access Macedonian Journal of Medical Sciences, 10(B), pp. 1107–1112.
Ministry of Health Republic Indonesia (2019) RISKESDAS National Report 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan.
Mirzaei-Alavijeh, M. et al. (2023) ‘Determinants of medication adherence in hemodialysis patients: A cross-sectional study based on capability-opportunity-motivation and behavior model’, BMC Nephrology, 24(1), pp. 1–8. doi: 10.1186/s12882-023-03231-0.
Mukakarangwa, M. C. et al. (2020) ‘Motivators and barriers of adherence to hemodialysis among patients with end-stage renal disease (ESRD) in Rwanda: A qualitative study’, International Journal of Africa Nursing Sciences, 13(March), p. 100221. doi: 10.1016/j.ijans.2020.100221.
Mundakir, M. et al. (2019) ‘The relationship between partner support and interdialytic weight gain (IDWG) hemodialysis patient’, Jurnal Ners, 14(2), pp. 210–214.
Naalweh, K. S. et al. (2017) ‘Treatment adherence and perception in patients on maintenance hemodialysis: A cross-sectional study from Palestine’, BMC Nephrology, 18(1), pp. 1–9. doi: 10.1186/s12882-017-0598-2.
Nielsen, T. M. et al. (2023) ‘Non-adherence, medication beliefs and symptom burden among patients receiving hemodialysis -a cross-sectional study’, BMC Nephrology, 24(1), pp. 1–10. doi: 10.1186/s12882-023-03371-3.
Niihata, K. et al. (2017) ‘Association of coping strategies with mortality and health-related quality of life in hemodialysis patients: The Japan Dialysis Outcomes and Practice Patterns Study’, PLoS ONE, 12(7), pp. 1–13. doi: 10.1371/journal.pone.0180498.
Ok, E. and Kutlu, Y. (2021) ‘The effect of motivational interviewing on adherence to treatment and quality of life in chronic hemodialysis patients: A randomized controlled trial’, Clinical Nursing Research, 30(3), pp. 322–333. doi: 10.1177/1054773820974158.
Pretto, C. R. et al. (2020) ‘Quality of life of chronic kidney patients on hemodialysis and related factors’, Revista Latino-Americana de Enfermagem, 28(e3327), pp. 1–11. doi: 10.1590/1518-8345.3641.3327.
Quality Division of PKMK FK UGM (2024) Kemenkes sebut gagal ginjal jadi penyakit dengan beban kematian tinggi.
Sapkota, A. et al. (2022) ‘Adherence to Treatment among Patients With End-Stage Renal Disease Undergoing Hemodialysis In Selected Centers In Nepal’, Journal of Nepal Health Research Council, 20(1), pp. 72–78. doi: 10.33314/jnhrc.v20i01.3828.
Sheikh, V. et al. (2022) ‘Factors related to treatment adherence behaviors among old-age hemodialysis patients in Hamadan, Iran: The application of the extended theory of planned behavior during Covid-19 pandemic’, BMC Nephrology, 23(1), pp. 1–9. doi: 10.1186/s12882-022-02694-x.
Sousa, H. et al. (2023) ‘Designing family-based interventions in kidney failure: The perspectives of the triad ’patients on haemodialysis/family caregivers/healthcare professionals’, British Journal of Health Psychology, 28(3), pp. 672–689. doi: 10.1111/bjhp.12647.
Stømer, E. U. et al. (2020) ‘Health literacy in kidney disease: Associations with quality of life and adherence’, Journal of Renal Care, 46(2), pp. 85–94. doi: 10.1111/jorc.12314.
Sultan, B. O., Fouad, A. M. and Zaki, H. M. (2022) ‘Adherence to hemodialysis and medical regimens among patients with end-stage renal disease during COVID-19 pandemic: A cross-sectional study’, BMC Nephrology, 23(1), pp. 1–9. doi: 10.1186/s12882-022-02756-0.
Syamsiah, N. (2011) Faktor-faktor yang berhubungan dengan kepatuhan pasien CKD menjalani hemodialisia di RSPAU Dr. Esnawan Antariksa Halim Perdana Kusuma Jakarta. Universitas Indonesia.
Tiksnadi, B. B. et al. (2023) ‘Validation of Hospital Anxiety and Depression Scale in an Indonesian population: A scale adaptation study’, Family Medicine and Community Health, 11(2), pp. 1–8. doi: 10.1136/fmch-2022-001775.
Ulusoy, S. I. and Kal, Ö. (2020) ‘Relationship among coping strategies, quality of life, and anxiety and depressive disorders in hemodialysis patients’, Therapeutic Apheresis and Dialysis, 24(2), pp. 189–196. doi: 10.1111/1744-9987.12914.
Utami, M. P. S. and Dwi Susanti, B. A. (2022) ‘Awareness questionnaire Indonesian version for chronic kidney disease (CKD) patients with hemodialysis: Development and validity’, Jurnal Ilmiah Kesehatan Sandi Husada, 11(1), pp. 175–181. doi: 10.35816/jiskh.v11i1.720.
Wen, J. et al. (2023) ‘Mental health and its influencing factors of maintenance hemodialysis patients: A semi‑structured interview study’, BMC Psychology, 11(84), pp. 1–11. doi: 10.1186/s40359-023-01109-2.
Xu, F. et al. (2023) ‘Knowledge, attitude, and practice of patients receiving maintenance hemodialysis regarding hemodialysis and its complications A single-center, cross-sectional study in Nanjing’, BMC Nephrology, 24(275), pp. 1–10.
Yasin, F. et al. (2024) ‘Factors influencing self-care management in adult hemodialysis patients: An integrative review’, Qatar Medical Journal, 1(12), pp. 1–17. doi: 10.5339/qmj.2024.12.
Zher, W. L. and Bahari, R. (2022) ‘Relationship between resilience, depression, stress, anxiety, and treatment adherence amongst hemodialysis patients’, Journal of Positive School Psychology, 6(7), pp. 5550–5564.
Copyright (c) 2024 Jurnal Ners
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Ners agree to the following terms:
- Authors transfer the Copyright and grant Jurnal Ners the right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Jurnal Ners.
- Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Ners.
Jurnal Ners requires a formal written declaration and transfer of copyright from the author(s) for each article published. We, therefore, ask you to complete and return this form, retaining a copy for your own records. Your cooperation is essential and appreciated. Any delay will result in a delay in publication. The form can be downloaded HERE.
