Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients

Abstract

Patients with chronic kidney disease (CKD) often require regular hemodialysis (HD) to prolong life. However, between HD sessions, patients have to restrict their diets carefully to avoid excess accumulation of potassium, phosphate, sodium, and fluid, which their diseased kidneys can no longer regulate. Failure to adhere to their renal dietary regimes can be fatal; nevertheless, non-adherence is common, and yet little is known about the psychological variables that might predict this dietary behavior. Thus, this study aimed to assess whether dietary adherence might be affected by a variety of psychological factors including stress, personality, and health locus of control, as well as dietary knowledge, in chronic HD patients. Fifty-one patients (30 men; age range 25–85) who had undergone HD for at least 3 months and had been asked to restrict at least one of potassium, phosphate or fluid, were recruited from a hospital renal unit. Measures of adherence to each of potassium, phosphate, and fluid were derived from standard criteria for these physiological indices in renal patients. Knowledge of food/drink sources of these dietary factors, and their medical implications in relation to HD and CKD were assessed by a bespoke questionnaire. Psychological factors including stress, personality and health locus of control beliefs were measured by standardized questionnaires. Having to restrict a particular nutrient was associated with better knowledge of both food sources and medical complications for that nutrient; however, greater dietary knowledge was not linked to adherence, and knowledge of medical complications tended to be associated with poorer adherence to potassium and phosphate levels. Adherence to these two nutrient requirements was also associated with lower reported stress in the past week. Adherence was associated with differences in locus of control: these differences varied across indices although there was a tendency to believe in external loci. For potassium, phosphate, and fluid restriction, adherers were less likely to be sensation seekers but did not differ from non-adherers on impulsivity, anxiety sensitivity, or hopelessness. In conclusion, the links between dietary adherence and stress, locus of control and personality suggests that screening for such psychological factors may assist in managing adherence in HD patients.

Relationship between spiritual health and hope by dietary adherence in haemodialysis patients in 2018

“…The results of this research indicate the adherence of most patients (69.1%) to the fluid regimes and the preservation of an interdialytic weight gain of <2 kg. This is in line with the studies of Esmaeili et al () and Gibson et al (). In this regard, the results of some of the other studies (Lee & Molassiotis, ; Rambod, Peyrovi, Sareban & Mohebbi., ) that reported on the rate of non‐adherence to the fluid regime by 59.7% and 56%, respectively, were different from the results of the present study.…”

“…The present study represented that most patients (89.1%) had a normal range of potassium, indicating that most patients were adherent to the low‐potassium diet. In this regard, this research is similar to the studies conducted by Gibson, Held, Khawnekar, and Rutherford () and Esmaeili et al (), which showed a potassium level in the range of 60%–96% in dialysis patients. It is worth noting that 65.5% of patients were in the expected range for their phosphorus level and they were adherent to the low‐phosphorus diet.…”

“…However, there was a significant relationship between spiritual as well as existential well-being and the underlying disease (r = −.204 and p = .032, r = −.188 and p = .049). Esmaeili et al (2013) and Gibson et al (2016). In this regard, the results of some of the other studies (Lee & Molassiotis, 2002;Rambod, Peyrovi, Sareban & Mohebbi., 2008) that reported on the rate of non-adherence to the fluid regime by 59.7% and 56%, respectively, were different from the results of the present study.…”

The Frustrating Attempt to Limit the Interdialytic Weight Gain in Patients on Chronic Hemodialysis: New Insights Into an Old Problem

“…[10][11][12][13][14][15][16][17] Numerous barriers, psychological (low motivation) or social (insufficient support from family, friends, providers, and peers), lack of knowledge (lack of understanding of what they were taught), and lack of self-assessment (being unable to judge overall fluid status, fluid intake, or salt intake) have been shown to be related to failed adherence to fluid restriction. [14][15][16][17] However, the main causes of poor adherence to fluid restriction and of excessive intake of fluids are thirst and xerostomia defined as the subjective feeling of a dry mouth. 18 The physiological basis of thirst is complex in healthy individuals as well in patients with acute and chronic diseases.…”

Cuidado, Doença E Saúde: Representações Sociais Entre Pessoas Em Tratamento Dialítico

“…17 The emphasis of the evaluative aspect in CKD care shows that this practice in people with end-stage renal disease is linked to the constraints in managing salt, liquid and food limitation in order to prevent complications that consist of stressors of the disease and which require regulated behavior. 2 A study 18 on the link between stressors and renal dietary adherence reveals that the restriction to a given food is associated with better knowledge regarding the food and complications related to it. This same study shows that people with high perceived control are more adherent to fluid control.…”