Kathmandu University, Nepal
Niru Khatiwada has completed her Master of Nursing in 2015 from Maharajgunj Nursing Campus and this theses has been completed as a partial requirement of the degree and is currently working as a lecturer in Kathmandu University affiliated Nepal Medical College, Attarkhel, Jorpati, Kathmandu.
Treatment adherence with four domains: hemodialysis schedule, diet restriction, fluid restriction and medicine adherence, is a crucial factor that influences morbidity and mortality of hemodialysis patients. The aim of the study was to assess treatment adherence among patients undergoing hemodialysis and the associated factors in the year 2014. Methods: A total of 166 patients undergoing hemodialysis for at least 3 months in National Kidney Center, Kathmandu were interviewed. Patients with communication problems and those who were too sick for interview were excluded. Relationship between four domains and various factors were identified using inferential statistics. Results: The self-reported treatment adherence was found to be 73.5%, 32.5%, 39.8% and 78.9% in hemodialysis schedule, diet restriction, fluid restriction and medicine adherence respectively. Adherence to hemodialysis schedule was significantly associated with duration of hemodialysis (p=0.050), companion to reach the center (p=0.038), time to reach the center (p=0.020) and type of transportation (p=0.004). Fluid restriction had significant association with marital status (p=0.034), adequacy of treatment expenditure (p=0.015) and Interdialytic Weight Gain (IDWG) (p=0.012). Adherence to diet restriction had significant association with counseling on the same (p=0.013). Medicine adherence was significantly associated with age (p=0.017) and duration of hemodialysis (p=0.049). It also showed association of age (p=0.001), Hepatitis C infection (p=0.013), Diabetes mellitus (p=0.012), duration of hemodialysis (p=0.010) with IDWG. Conclusion: There is an immediate need for strategies to promote the treatment adherence of the patients under hemodialysis with focus on diet and fluid restriction adherence.
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