Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review

Oquendo, Lissete González; Asencio, José Miguel Morales; Nieves, Candela Bonill de las

doi:10.1111/jocn.13804

Cited by 40 publications

(32 citation statements)

References 34 publications

(125 reference statements)

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“…Family support as a motivator of adherence to integrated management has been highlighted in the study. These results were similar to the findings of Ghimire et al (2017), Griva et al (2013) and González Oquendo et al (2017). Furthermore, family support has been shown to maintain the quality of life and to improve coping mechanisms among patients with CKD (Tannor et al, 2017).…”

Section: Discussionsupporting

confidence: 88%

“…In view of few published studies in other regions, social support in the form of family and friends has been included as a motivator of adherence behavior (Ghimire, Castelino, Jose, & Zaidi, 2017;González Oquendo, Morales Asencio, & Bonill de las Nieves, 2017;Maxia et al, 2016). Maxia et al (2016) further highlighted the crucial role of involving family support in the attainment of compliance among patients with CKD.…”

Section: Background and Literature Reviewmentioning

confidence: 99%

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Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Chironda

Bhengu

2018

Nursing & Health Sciences

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The integrated management of chronic kidney disease (CKD) demands significant changes, as patients need to adhere to dialysis, medication, and dietary and fluid restrictions. Therefore, there is a need to identify the motivators of adherence to improve the quality of life of these patients. The aim of the present study was to explore the motivators of adherence to integrated management among patients with CKD in South Africa. A phenomenological design was used. A sample size of 12 participants was selected according to data saturation. The purposive sampling method was used to select the participants. Data were collected with the help of a semistructured interview schedule developed from the literature. A thematic framework analysis was conducted to identify the motivators of adherence to integrated management; these were found to be family support, anxiety about eligibility for kidney transplant, support of other patients, awareness of complications associated with non-adherence to integrated management, and fear of being removed from the CKD program. Identified motivators could be used to develop specific interventions that address or foster adherence behavior as a requirement for integrated management.

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Section: Discussionsupporting

confidence: 88%

Section: Background and Literature Reviewmentioning

confidence: 99%

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Chironda

Bhengu

2018

Nursing & Health Sciences

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“…In fact, depression could be responsible for non-adherence with treatment through behavioural pathways [26]. A recent quantitative review reported that depressed patients with a chronic illness are about threefold noncompliant to medical treatment than non-depressed patients [27]. Similarly, depressive disorder in dialysis was associated with double risk of no compliance to calcium-phosphorus dietary prescriptions [26].…”

Section: Discussionmentioning

confidence: 99%

Depressive Symptoms in Dialysis: Prevalence and Relationship with Uremia-Related Biochemical Parameters

et al. 2018

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Background: Depression is the most common psychiatric disorder in long-term dialysis patients and a risk factor for morbidity and mortality. Although there is a relevance of the issue in the dialysis setting, we still know little about possible relationships between depression and uraemia-related biochemical abnormalities. Our aims were to evaluate (1) the prevalence of depression in our haemodialysis (HD) and peritoneal dialysis (PD) population using a validated and easy-to-implement screening tool and (2) the association between depression and the main uraemia-related clinical and biochemical parameter changes. Methods: In this monocentric cross-sectional study, all patients of our centre with at least 3 months of dialysis were screened by Patient Health Questionnaire-9 (PHQ-9), a self-administered depression-screening questionnaire validated in dialysis setting. The impact of depressive symptoms on daily life was also assessed. We then analysed relationships between the PHQ-9-derived depressive score, functional impairment score, demographic, clinical and laboratory variables. Results: In our cohort of 145 patients, depressive symptoms were found in 69 patients (46%). Stratifying for severity, mild, moderate and severe grade accounted for 31, 13 and 2% respectively. Depressive symptoms affected 36% of patients on PD versus 52% of patients on HD. Moreover, the PD patients had significantly less functional impairment derived from depressive symptoms than the HD patients. Simple and multiple regression analysis identified serum phosphorus as the only uraemia-related laboratory parameter that was high statistically associated with depressive score. Conclusions: Using a reliable, simple and fast tool, we found that depressive symptoms affect almost half of dialysis patients, particularly so the HD cohort. Severity of depressive symptoms seems related to serum levels of phosphorus possibly because depression affects compliance to therapy.

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“…25 Additionally, with depression and self-reported poorer mental health also impacting on activation, 22,23 an interdisciplinary approach to care including psychology may be required to address motivational barriers. 26 In the present study, one in five patients felt they saw a dietitian when they did not need it, and 50% reported a preference to see a dietitian when they have a question or concern rather than at predefined intervals. This suggests that dietetics services for dialysis patients may need to shift towards models with care provided where and when desired by the patient, rather than at set intervals as dictated by guidelines.…”

Section: Percentage Of Respondentsmentioning

confidence: 52%

“…Given these motivational barriers, exploring decisional balance with patients, building relationships and high level motivational interviewing skills of clinicians are likely to be important strategies in supporting people with chronic disease to achieve good health outcomes . Additionally, with depression and self‐reported poorer mental health also impacting on activation, an interdisciplinary approach to care including psychology may be required to address motivational barriers …”

Section: Discussionmentioning

confidence: 99%

Guidelines for review of patients on haemodialysis: Are we meeting patient needs?

Morgan

Jersey

Mason

et al. 2019

Nutrition & Dietetics

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Aim This study aimed to determine satisfaction with dietetic services, identify barriers and enablers to engaging with dietetic services and acceptable methods of delivering nutrition care to patients on haemodialysis. Methods A questionnaire was developed based on existing satisfaction surveys and key constructs from the Theoretical Domains Framework to understand patient behaviours around accessing dietetic services. Constructs were grouped according to the COM‐B model (Capability, Opportunity and Motivation) of the Behaviour Change Wheel to inform future interventions. Patients at three Brisbane haemodialysis units participated, with questionnaire administered via laptop (by dietetic assistants) or paper‐based version (by nurses). Results Sixty‐six patients completed the questionnaire (response rate 40%, 62 ± 14 years, 58% male). Most respondents (n = 63, 95%) reported seeing a dietitian since commencing haemodialysis. A quarter of respondents reported declining or not wanting to see the dietitian. Despite this, questions pertaining to service satisfaction were largely positive. Questions related to enablers and barriers to engaging with the dietitian revealed the domain of motivation as the main barrier with 41% (n = 26) participants not wanting to make dietary changes. The domains of capability and opportunity were not barriers. Patients preferred receiving nutrition information from dietitians, when they had a question or concern, rather than at predefined intervals. Telehealth was not acceptable to the majority of participants. Conclusions While patients were satisfied with dietetic care, their preferences for dietetic service delivery were not aligned with current evidence‐based guidelines, highlighting need for alternative models of care. Dietetic interventions need to be delivered in a way that addresses motivation.

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Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review

Cited by 40 publications

References 34 publications

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Depressive Symptoms in Dialysis: Prevalence and Relationship with Uremia-Related Biochemical Parameters

Guidelines for review of patients on haemodialysis: Are we meeting patient needs?

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