Family support, physical impairment, and adherence in hemodialysis: An investigation of main and buffering effects

Abstract

Patient noncompliance is a pervasive problem among end-stage renal disease (ESRD) patients. Previous studies have implicated social support as an important correlate of adherence behavior in other chronic illness groups, but little research has examined this relationship in a hemodialysis population. The present study examined the main and interactive effects of social support in the family and illness-related physical impairment with regard to patient compliance in a sample of 78 hemodialysis patients. Results indicated that patients holding perceptions of a more supportive family environment exhibited significantly more favorable adherence to fluid-intake restrictions than did patients reporting less family support. Family support was not associated with adherence to dietary restrictions. The effect of family support on fluid-intake adherence was not moderated by level of physical impairment. This pattern suggests that the influence of support on adherence is more attributable to a main or direct effect, as opposed to a buffering process in the face of increased physical impairment.

An offline mobile nutrition monitoring intervention for varying-literacy patients receiving hemodialysis: a pilot study examining usage and usability

“…1 Effective dietary selfmanagement helps prevent poor health outcomes. Inadequate self-management may lead to increased blood pressure, 2 reduced heart, 3 physical, 4 and cognitive function, 5 reduced bone health, 6 and increased mortality. 7 8 Unfortunately, the target population often lacks the computational, literacy, and memory skills necessary to track their fluid and nutrient intake.…”

Psychosocial Aspects of Chronic Disease

“…156,161,163,164 Several studies have shown an association between survival and perception of social support in ESRD patients of different ethnic backgrounds. 71,95,160,161,[165][166][167] McClellan et al showed, in a prospective study, that a QOL measure, which included social support, predicted survival of HD patients. 166 Christensen et al showed family cohesion, as a social support indicator measured by the Family Environment Scale, predicted survival in HD patients.…”

“…71,79,160,161,169 In a study of HD patients in Utah, patients who perceived high family support had lower levels of interdialytic weight gain and better biochemical compliance measures. 160 Leggat et al, in a large study performed using data from the United States Renal Data System, found patients living with someone, rather than living alone, were less likely to shorten HD treatments. 83 There was, however, no association of household composition with attendance, interdialytic weight gain, or level of serum phosphate.…”

Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research.

“…Limited research is available regarding adherence among ESRD patients. Christensen et al (1992) examined the effects of social support in the family and illness-related stress on hemodialysis patient adherence. Results indicated that patients holding perceptions of a more supportive family environment, characterized by greater cohesion and expressiveness among family members and less intrafamily conflict, exhibited significantly more favorable adherence to fluid-intake restrictions than did patients reporting less family support.…”