Family relations, mental health and adherence to nutritional guidelines in patients facing dialysis initiation

Abstract

This study investigated the effect of family relations on patients' adjustment to dialysis. The two main aims were to develop a family typology, and to explore the influence of family profile on the patient's anxiety, depression and adherence to nutritional guidelines. The sample consisted of 120 patients (mean age 63 years; 67.5% of men). They completed several measures 1, 6 and 12 months after dialysis initiation. The scales used were the Family Relationship Index and the Hospital Anxiety and Depression Scale. Perceived adherence to nutritional guidelines was assessed using two visual analogical scales. Results showed that family relations remained stable over time. Cluster analysis yielded three family profiles, which were named conflict, communicative and supportive families. Patients belonging to conflict families perceived themselves as less adhering to nutritional guidelines. For these patients, anxiety and depressive moods increased significantly over time, whereas mental health remained stable over time for communicative and supportive families. This research underlines that family relations are essential in global consideration of the care of patients treated by dialysis. Conflict families seem especially at risk. They should be identified early to help them adapt to this stressful treatment.

Social support and treatment adherence in patients with end‐stage renal disease: A systematic review

“…In this review, all studies that applied the MSPSS and considered its different factors (vs a total score), found significant associations with treatment adherence. Instead, most studies measuring social support with an overall score failed to sustain these results . These findings are congruent with previous literature, pointing that individuals usually differentiate between different tangible sources of support …”

“…Four studies (100%) reported significant associations between social support and overall treatment adherence. These studies highlighted the role of caregivers, healthcare providers, and family relationships and support . Congruent results were found by Varghese and colleagues who reported a significant association between social support and overall adherence, measured by biochemical indicators of serum phosphate and inter‐dialytic weight gain …”

Factors associated with adoption of coping strategies among Chinese patients with heart failure in ethnic minority regions

“…We found that those who were capable of taking care of themselves were apt to acceptance resignation coping strategy, while those patients who were unable to do so relied more on caregivers assistance to manage their illness. Previous studies showed that supportive family relationship reduced the perception of stress and facilitated active coping and recovery of patients with chronic illnesses (Schuster, Hammitt, & Moore, 2003;Untas, Rascle, Idier, Lasseur, & Combe, 2012). Thus, support from caregivers was crucial for improving the self-management and recovery, thereby enhancing their ability to cope with disease positively (Schuster et al, 2003).…”

Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift

“…Validated measures show a strong association between treatment adherence, engagement with outpatient resources, and mortality outcomes . Symptoms of anxiety and depression are extremely common and linked with dialysis and dietary nonadherence behaviors . Kimmel et al showed that perception of burden of illness and poor social support correlate with treatment of nonadherence, frequent hospitalization, and mortality .…”

“…Social support plays a role in self‐efficacy. Support from family and friends is associated with better fluid adherence, and higher rates of social support are associated with improved dialysis treatment adherence . Over 30% of patients on hemodialysis have poor social support based on medical outcomes study surveys .…”