Factors Affecting Non-Adherence to Treatment in End Stage Renal Disease (ESRD) Patients Undergoing Hemodialysis in Indonesia

Abstract

Background: Non-adherence to treatment regimens is a widespread problem of great clinical relevance among hemodialysis patients. However, only few studies have addressed the factors of non-adherence in End Stage Renal Disease (ESRD) patients, and none conducted in the Indonesia. Objective: The present study explores the reasons of non-adherence in end stage renal disease patients undergoing hemodialysis in Indonesia seen from perspectives of patients, caregivers and health professionals. Methods: The study is conducted using qualitative methods and is set in the hemodialysis unit in a private hospital in Bandung. A total of 23 respondents were recruited in this study. All participants were selected through purposive sampling and invited to participate in semi-structured interviews with open-ended questions. The data obtained were written in verbatim and analyzed using thematic analysis. Results: The six main themes related to non-adherence emerged. These themes were categorized into two clusters namely: (1) factors related to patient (patient related factors) (negative perception and treatment belief, denial, lack of awareness and knowledge and negative feelings) and (2) factors related to the treatment (treatment burden and financial problems). Conclusion: The findings showed determinants of non-adherence in ESRD patients from perspective of patients, caregivers and health professional. The finding from this study can be used as a base for designing an intervention, aimed to increase the adherence to treatment in ESRD patients who are undergoing hemodialysis.

Peningkatan Kepatuhan Penderita Gagal Ginjal Kronik Dalam Menjalani Hemodialisa Di Rumah Sakit Umum Imelda Pekerja Indonesia Medan Tahun 2022

“…Kepatuhan pada menjalani hemodialisa sangat menunjang pada peningkatan kesehatan serta kesejahteraan pasien. Kepatuhan ialah aspek penting untuk menghipnotis kualitas hayati pasien penderita gagal ginjal kronik, apabila pasien tidak patuh dalam menjalani terapi hemodialisis akan terjadi penumpukan zat-zat berbahaya berasal tubuh yang akan terjadi metabolisme pada darah sebagai akibatnya penderita akan merasa sakit semua tubuh serta bila hal tadi dibiarkan akan mengakibatkan kematian (Al-Khattabi, 2020;Chan et al, 2012;Kustimah et al, 2019).…”

“…Berdasarkan wawancara ditemukan bahwa jarak pelayanan dan penderita menjadi alasan utama sebagai faktor penghambat penderita menjadi tidak patuh. Kurangnya pengetahuan yang memadai, kemampuan efikasi diri yang tidak memadai, kelupaan dan kendala keuangan merupakan hambatan utama yang dirasakan terhadap kepatuhan yang lebih baik terhadap cairan, diet, pengobatan dan dialisis, masing-masing (Chan et al, 2012;Kustimah et al, 2019).…”

Faktor-Faktor yang Memengaruhi Peningkatan Interdialytic Weight Gain (IDWG) pada Pasien Hemodialisa

“…Jaminan Kesehatan Nasional Indonesia menempatkan penyakit ginjal kronik sebagai salah satu dari empat penyakit teratas dalam hal pengeluaran kesehatan nasional (BPJS Kesehatan, 2020). Selain itu, pasien juga mengalami keterbatasan fisik dan penurunan pendapatan dikarenakan harus menjalani rawat inap yang berulang serta meningkatnya pengeluaran untuk biaya kesehatan (Kustimah et al, 2019).…”

Psychometric Properties of an Instrument to Determine the Factors Affecting Treatment Adherence Among Patients Receiving Hemodialysis in Sri Lanka

“…Thus, before planning any interventions to improve the clinical outcomes of the patients on dialysis, all the potential determinants that influence their adherence behavior should be taken into consideration ( 11 ). Periodic assessment and identification of the factors associated with nonadherence permit planning future interventions ( 14 ) while providing a basis to make alterations of the present treatment regimen to deliver quality and safe patient care. Very few studies explored adherence to the hemodialysis treatment regimen in Asian populations ( 11 ).…”