Psychosocial influencers and mediators of treatment adherence in haemodialysis patients

Psychosocial influencers and mediators of treatment adherence in haemodialysis patients
서화숙; 오현수
compliance, cross-sectional design, dialysis, psychosocial nursing
Issue Date
Series/Report no.
JOURNAL OF ADVANCED NURSING ; Vol69 no.9 Startpage 2041 Endpage 2053
Aim. This article is a report of the development and testing of the hypotheticalmodel that illustrates relationships between treatment adherence and itspsychosocial influencing factors and to elucidate the direct and indirect(mediating) effects of factors on treatment adherence.Background. Poor adherence has been consistently reported in haemodialysispatients. Much research has showed various influencing factors of adherence, butthese studies have failed to identify consistent influencing factors.Design. This study was performed using a non-experimental, cross-sectionaldesign.Methods. The study subjects were 150 end-stage renal failure patients onhaemodialysis at a university hospital located in Incheon, South Korea. Data werecollected over 10 months (June 2010?April 2011).Findings. The hypothetical model provided a good fit with data. Haemodialysis-related knowledge, perceived barrier to adherence, self-efficacy on adherence,and healthcare provider support had significant effects on adherence. Self-efficacywas found to mediate barrier?adherence and family support?adherencerelationships. Self-efficacy in combination with barrier, family support, andhealthcare provider support was found to mediate the depression?adherencerelationship.Conclusion. Strategies aimed at the development of successful adherenceinterventions should focus on reducing perceived barriers and enhancing self-efficacy and knowledge. It can be suggested that efforts to improve the healthcareprovider?patient relationship would enhance adherence. In depressive patients,strategies that promote self-efficacy and the support of family or healthcareproviders could diminish the negative impact of depression on adherence.
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