Nonadherence in Hemodialysis Patients and Related Factors: A Multicenter Study.
Nurten Ozen, Fatma Ilknur Cinar, Dilek Askin and 2 others
PMID 30720548WHAT IT FOUND
Among 274 hemodialysis patients, nonadherence was 39.1% for diet and fluid, 33.6% for dialysis, and 20.1% for medication.
Men, a central venous catheter, and shorter dialysis duration were linked to higher dialysis nonadherence.
Key findings
01Nonadherence was 39.1% for dietary and fluid restrictions, 33.6% for HD treatment, and 20.1% for medication.
02In regression analysis, high school graduates had 4.337 times higher risk of nonadherence to dietary and fluid restrictions than illiterate subjects.
03Men had 2.074 times higher risk of nonadherence to HD treatment, central venous catheter patients had 2.591 times higher risk, and longer HD duration was associated with 0.992 times lower risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional descriptive study, so it cannot show that male sex, a central venous catheter, education, or dialysis duration caused nonadherence. It cannot show how adherence changes over time, and comorbid illnesses such as diabetes, hypertension, and cardiovascular disease were not controlled for. The study excluded patients with Alzheimer disease or psychiatric problems related to cognitive disorders, so findings may not apply to patients with those conditions. Patients were asked to think about the most recent month, which may make recall less reliable. The Hospital Anxiety and Depression Scale had reliability of .64 in this study.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that these factors cause nonadherence or that changing them will improve adherence. The study measured associations at one point and did not test an intervention to increase adherence.