The experience of adherence among hemodialysis patients undergoing therapeutic regimen: a qualitative study

Abstract

Background: Hemodialysis is one of the most widely used renal replacement therapies and the most efficient procedure for managing patients with end-stage renal disease. It can reduce the symptoms of the disease; however, it affects quality of life, resulting in major changes to all areas of life. Thus, patients must adhere to the therapeutic regimen of hemodialysis. Knowledge regarding the adherence of hemodialysis patients to their therapeutic regimens and their experience is needed as it forms the basis for developing comprehensive nursing care and broader nursing practices for renal disease patients. This study aimed to explore patients’ experience of adherence to the therapeutic regimen. Methods: The design of this study was formulated using a qualitative phenomenological approach with a purposive sampling method that involved interviewing 10 selected patients. Data analysis was performed using the Colaizzi method. Results: The results of this study revealed five themes: (1) the most difficult period is the beginning of the hemodialysis program; (2) it is important for patients to perform self-care; (3) nurses play a critical role in improving adherence; (4) there is a decrease in patients’ ability to perform physical activity; and (5) there are supporting and inhibiting factors of adherence to the therapeutic regimens in hemodialysis patients. Conclusions: Adherence to the therapeutic regimen fluctuates. Thus, there is a need to optimize the role of nurses in improving adherence.