Factors Associated With Adherence to Fluid and Dietary Restrictions Among Patients Receiving Hemodialysis From Dialysis Centers in Kampala

Abstract

Background: This study investigated the factors associated with adherence to fluid and dietary restrictions among patients receiving hemodialysis from dialysis centers in Kampala. Health literacy, perceived social support and comorbid conditions were the investigated factors. Self-reported adherence to fluid restrictions and inter-dialytic weight gain characterized fluid adherence. Self-reported adherence to diet restrictions, pre-dialytic serum potassium and phosphate characterized diet adherence.

General Objective: The study was intended to establish and recommend strategies and that could improve adherence to fluid and diet restrictions in hemodialysis patients in Uganda. The study was conceived due to the fact that there is a persistent problem of non-adherence to fluid and diet restrictions among hemodialysis patients.

Methodology: The study was conducted through cross-sectional survey; data was collected during the period between 27th August and 16th October 2012 using interview techniques from 42 hemodialysis patients receiving dialysis from Mulago hospital and Panorama hospital dialysis centers. Statistical analysis consists ofKruskal Wallis tests whose results were confirmed by doing a Kendall’s test.

Results: Twenty two percent of the respondents were female while 78% were male. Majority of the respondents were between ages 45 and 64 years old. The frequency of adherence to diet and fluid restrictions was 27.3% and 54.5% respectively. The study established that perceived social support had a significant effect on adherence to fluid restrictions (X2 = 4.305; df = 1; p = 0.02). The study also established that comorbidity had a significant effect on adherence to diet restrictions (X2 = 1.612; df = 1; p = 0.04) and fluid restrictions (X2 = 3.583; df = 1; p = 0.03). Health literacy was found to not have any significant effect on adherence to diet restrictions (X2 = 0.128; df = 1; p = 0.68) or fluid restrictions (X2 = 0.363; df = 1; p = 0.55).

Conclusion and recommendations:The study recommends that there is need to design and/or implement nursing and collaborative interventions that enhance the perceived social support of hemodialysis patients. Interventions should also be implemented to check the effect of comorbid conditions on adherence to fluid and diet restrictions among hemodialysis patients.