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Abstract
This research assesses the effectiveness of a specific approach to increase adherence to dialysis regimens. People undergoing dialysis as a renal replacement therapy are required to comply with difficult regimens to maintain as healthy a life style as possible. Without dialyzing the prescribed amount of time and limiting the fluids dialysis cannot improve their lives. Mortality and repeated hospitalizations are the result of non-adherence to the dialysis regimen.
Improved self-efficacy for following these dialysis regimens and planned strategies to help patients succeed are believed to increase their adherence and lead to improved quality of life. Understanding of self-efficacy and patient’s health locus of control can provide a framework for education to improve levels of self care.
This study measured self-efficacy, locus of control and quality of life for patients determined by their medical record to be non-adherent. Patients found to be non-adherent were randomly assigned to a control group and an experimental group. The experimental group was given a specially designed brief intervention in addition to the educational material provided the control group. The intervention was geared to promote their involvement and responsibility for their own care (locus of control) and support for their belief in their ability to adhere to their dialysis regimens (self-efficacy). The measures of self-efficacy, locus of control and quality of life, and measures of adherence were repeated at baseline, three months, and six months.
The hypothesis was that self-efficacy and adherence would improve following the intervention, self-recording, and self-efficacy building techniques. Health locus of control was hypothesized to have a moderating effect on adherence. It was further hypothesized that patient quality of life would improve with better management of their dialysis regimen.
The results showed significant improvement (p=.0158) in self-efficacy and nonsignificant improvement in adherence. Significant improvements were made in the shortened dialysis time treatment group’s mean internal locus of control (p<.001), Burden of Kidney Disease (p=.0415) and Symptoms and Problems (p=.0092) domains of KDQOL-36 Quality of Life measure.
