Psychosocial and Cognitive Factors Associated with Adherence to Dietary and Fluid Restriction Regimens by People on Chronic Haemodialysis

Sensky, Tom; Léger, Christine; Gilmour, Steven G.

doi:10.1159/000289029

Cited by 67 publications

(56 citation statements)

References 23 publications

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“…Depressive affect can directly influence poor adherence to diet and fluid regimens (16). Furthermore, chemical brain alterations in depressed patients may affect cognitive dysfunction (which may manifest as poor adherence) (17), and cognitive dysfunction has been associated with depressive affect in HD patients (18).…”

Section: Discussionmentioning

confidence: 99%

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk.Design, setting, participants, & measurements All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting .24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions ("down in the dumps" and "downhearted and blue"). A high depressive affect score corresponded with an average response of "some of the time" or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively.Results Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models.Conclusions Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future studies are needed to investigate the effect of therapeutic interventions to address depressive affect in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…The commonest sources of data for adherence to medications and dietary restrictions are sequential values of biochemical indices [5] which have direct implications for health outcome. The frequently used measures are interdialytic weight gain (IWG), as an index of compliance for fluid intake, predialysis serum potassium (K) and blood urea nitrogen (BUN) as measures of dietary compliance and serum phosphate (PO 4 ) as a parameter for medication intake [6,7].…”

Section: Introductionmentioning

confidence: 99%

Compliance in Hemodialysis Patients: Unanticipated Monitoring of Biochemical Indices

Arıcı

Altun²,

Usalan³

et al. 1998

Blood Purif

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Compliance with the prescribed medical regimen is a critical factor for the continued well-being of hemodialysis patients. As compliance is a multifactorial problem, numerous approaches have been utilized to quantify the compliance of hemodialysis patients. In the present study, we have attempted to examine whether unanticipated control of biochemical indices might predict the compliance status of hemodialysis patients. We compared unanticipated mid-month values of blood urea nitrogen (BUN), serum potassium (K) and phosphate (PO₄) values of 54 maintenance hemodialysis patients with the scheduled, regular first-week measurements during a 6-month study period. The interdialytic weight gain (IWG) levels of the corresponding weeks were also compared. Mid-month analysis revealed a significant deviation in the compliance status of the study population as BUN, serum K and IWGs were concerned (p < 0.05). The mid-month serum PO₄ levels were also higher but the difference was not significant (p < 0.05). In conclusion, the differences observed in biochemical indices upon change of test request timing were distinctive. It suggests that unanticipated control of biochemical indices might contribute to the actual assessment of compliance in hemodialysis patients.

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“…Some of the findings have suggested that non-compliance among haemodialysis patients is a complex affair which can arise from family stress, anxiety and discord [11, 12, 13]. Further variables include: malnutrition as a result of an unimaginative or incomprehensible dietary regime [12], the absence of a supervised, ongoing exercise programme [15], health beliefs and personality [6], the onset of emotional fatigue or depression [17, 18, 19], social worker input [13], participatory control of patients [20], patient reward systems [21]and counselling [22, 23, 24, 25, 26]. …”

Section: Discussionmentioning

confidence: 99%

“…These include a single or combination of measures at either one point in time or over a specified period [5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. …”

Section: Diagnosis Of Non-compliance In Patients Receiving Haemodialysismentioning

confidence: 99%

“…In addition, the type of haemodialyser was noted for each patient. Over a 26-month period it was found that lower levels of social support, decreased behavioural compliance with haemodialysis, and a negative perspective of the illness were associated with a significantly increased risk of mortality [12]. This study served to emphasise the relationship between psycho-social well-being and compliance with haemodialysis.…”

Section: Psycho-social Factors Involved In Non-compliancementioning

confidence: 99%

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