Supervisors info:
Βικτώρια Αλικάρη, Λέκτορας, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Μάτζιου Βασιλική, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Δήμητα Παϊκοπούλου, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Summary:
Self-efficacy plays a vital role in delaying the progression of Chronic Kidney Disease (CKD) and has been found to be related to quality of life. Adherence to treatment regimen appears to be related to self-efficacy. However, the relationship between pain self-efficacy and adherence to treatment in patients on hemodialysis has not been extensively examined.
AIM: To investigate the relationship between the level of knowledge of patients under hemodialysis with the level of adherence to the treatment and their pain self-efficacy.
METHOD: The present study is a cross-sectional study. The study sample consisted of 98 patients undergoing chronic periodic hemodialysis at the Hemodialysis Unit "Athinaiko center of Nefros". Data collection was carried out through a questionnaire, which consisted of 4 parts: a) patient socio-demographic information sheet, b) the Kidney Disease Questionnaire (KDQ) to measure the level of knowledge about CKD and the treatment, c) the GR-Simplified Medication Adherence Questionnaire-HD (GR-SMAQ-HD) to measure patients' adherence to the hemodialysis regimen, and d) the Pain Self Efficacy Questionnaire (PSEQ) to measure pain self-efficacy. Statistical analysis was performed with SPSS v.28. The level of statistical significance was set at α=0.05.
RESULTS: Of the 98 patients, 58 (59.2%) were male. The majority of participants were married (59.2%) and had at least 1 child (78.6%). Regarding education level, the majority (37.8%) were high school graduates. Also, 54.1% were retired. The median (25th – 75th percentile) time since disease diagnosis was 6.00 (4.00 – 9.00) years, while the median (25th – 75th percentile) time on dialysis was 4.00 (3.00 – 5.00) years. The main means of transportation for dialysis was the car (64.8%), followed by the taxi (19.3%).67.7% of patients underwent hemodialysis through a fistula.
The mean (SD) score of the PSEQ scale was 33.98 (±9.73), for the GR-SMAQ-HD 4.79 (±2.55) and for the KDQ 14.07 (±4.04). The KDQ scale was not found to have a statistically significant correlation with the GR-SMAQ-HD scale (rho=-0.080, p=0.432) and the PSEQ scale (rho=-0.133, p=0.192). Also, the GR-SMAQ-HD scale had no statistically significant correlation with the PSEQ scale (r=0.125, p=0.221).
Predictors of patient adherence to the treatment were: PSEQ score (b=0.056, p=0.032), marital status (married: b=1.631, p=0.016) and time since diagnosis (b= -0.158, p<0.001). On the other hand, predictors of knowledge level were female gender (b=1.925, p=0.005), vascular access (fistula: b=-2.771, p=0.001) and education level (junior high school graduate: b=2.942, p=0.032; high school graduate: b=3.258, p=0.012; university graduate: b=7.584, p<0.001). Finally, predictors of pain self-efficacy were GR-SMAQ-HD scale score (b=1.719, p<0.001) and time since diagnosis (b=0.709, p<0.001).
CONCLUSION: Patients had moderate adherence to regimen, moderate pain self-efficacy, and moderate knowledge. Adherence to treatment appears to be a predictor of patients' pain self-efficacy.
Keywords:
Knowledge, Compliance, Self-efficacy in pain, Hemodialysis
