A lot of recent medical articles have been written on problematic issues in the context of relations between physicians and patients, nurses and health care consumers. As for the hemodialysis procedure, frequency of treatments depends on the kidney failure stage, but in many cases three times a week are prescribed. Thus, dialysis sessions become a part of patients’ daily life and unfortunately different reports show that the level of non-adherence is very high. Factors which contribute to non-adherence in hemodialysis patients vary significantly and depend on individuality of a patient. It is difficult to analyze all off of them and it is worth dividing them into several groups. A review of literature has revealed basic reasons for patients’ non-attendance and they can refer to uncontrollable life conditions, psychological and physical state of a patient and finally, comfort level in hospitals, relationships with staff in clinics. Increase of non-adherence rates may result in poor and negative outcomes of medical treatment and therefore, it is important suggest new strategies in dialysis management.
Uncontrollable factors contributing to dialysis non-adherence are usually connected with some objective life conditions that prevent from patient’s possibility to access the hospital. One of the studies has focused on adherence barriers in the U.S. and excuses for missed hemodialysis appointments have been analyzed to investigate the most frequent and possible factors. Such barriers are represented by suboptimal transportation to a hospital, vacation, inclement weather and family events (Chan, Thadhani, Maddux, 2014: 2642). Another research on dialysis adherence considers pain and depressive symptoms common for this facility patients to be the most contributing aspect. According to the findings, “depression has been associated with decreased adherence to prescribed medications and dietary restrictions in patients” (Arnold et al., 2014: 1600). Indeed, moral and emotional state of a patient significantly influence the progress of treatment and overall physical health. On the other hand, people’s feelings and desire to attend depend on social interaction and dialysis staff encouragement (Blankestijn et al., 2012: 303). This fact is tightly connected with the notions of emotional and social pain experienced by patients. In some studies, people have reported on feeling themselves isolated due to the time constraints and lifestyle changes. It is very complicated to organize regular attendance for people having difficulties with movement and consistent fatigue (Bourbonnais & Tousignant, 2012: 16). Such a moral indisposition and weakness can lead to frequent missing of dialysis sessions and examinations. Besides, a strong and reliable cooperation between patients and medical staff is very important. Such differences in perspectives between two groups as theories regarding the cause of illness or frequency of treatment may result in mistrust towards physicians (Horne, Karamanidou, Weinman, 2014: 563).
One of the ways to approach the current problems is applying of the Health Belief Model which offers that an individual’s health is related to behaviors depends on their perception of four different areas, which include: severity of the illness, susceptibility of the illness, benefits of taking preventions and barrier to the action (Nursing theories, 2012). The model addresses the relationship between a person’s belief and behavior and provides an understanding and prediction of how a patient will behave in relation to their health and how they will comply with a health care treatment (Nursing Theories, 2012).
References
Blankestijn, P.; Bots, M.; Buskens, E.; de Wit, A.; den Hoedt, C.; Grooteman, M.; Mazairac,
A.; Nube, M.; Penne, L.; ter Wee, P.; van den Dorpel, M.; van der Weerd, N. (2012). Differences in quality of life of hemodialysis patients between dialysis centers. Quality Life Research, 21, 299-307.
Bourbonnais, F.; Tousignant, K. (2012). The pain experience of patients on maintenance
hemodialysis. Nephrology Nursing Journal, 39(1), 13-19.
Arnold, R.; Fine, M.; Green, J.; Mor, M.; Palevsky, P.; Sevick, M.; Shields, A.; Rollman, B.;
Weisbord, S. (2014). Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and Mortality in Patients Receiving Chronic Hemodialysis. CJASN, 9(9), 1594-1602.
Horne, R.; Karamanidou, C.; Weinman, J. (2014). A qualitative study of treatment burden
among hemodialysis recipients. Journal of Health Psychology, 19(4), 556-569.
Chan, K., Thadhani, R., Maddux, F. (2014). Adherence Barriers to Chronic Dialysis in the United States. Journal of American Society of Nephrology, 25(11), 2642-2648.
Nursing Theories. (2012). Health Belief Model. Retrieved on August 14, 2016 from
http://currentnursing.com/nursing_theory/health_belief_model.html
