Description of Nursing Problems and Factors Related to Therapy Compliance in Chronic Kidney Failure Patients Undergoing Hemodialysis

Vollständiger Abstract

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Chronic kidney disease (CKD) is a progressive condition with an increasing prevalence. Patients with CKD undergoing hemodialysis face multidimensional challenges, including physical and psychological symptoms, family support, health-service-related factors, nursing problems, and difficulties adhering to treatment. This study examined nursing problems and factors associated with treatment adherence among patients with CKD undergoing hemodialysis at Jakarta Islamic Hospital Cempaka Putih. This quantitative cross-sectional study included 54 respondents recruited through purposive sampling according to predefined inclusion and exclusion criteria. Treatment adherence was assessed using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). Physical, psychological, family support, and health service factors were assessed using questionnaires, whereas nursing problems were identified through medical-record review based on the Indonesian Nursing Diagnosis Standards (SDKI). Descriptive and bivariate analyses were performed using Spearman’s correlation test. The most common co-occurring nursing diagnoses were excess fluid volume, anxiety, and therapy nonadherence, identified in 25 respondents (46.3%). Physical factors were negatively associated with treatment adherence (r = −.323, p = .017), whereas health service factors were positively associated with treatment adherence (r = .393, p = .003). Psychological factors (r = −.117, p = .400) and family support (r = −.164, p = .236) were not significantly associated with treatment adherence. Among the examined variables, health service factors showed the strongest correlation with treatment adherence. Improving the quality of health services and addressing patients’ physical conditions may support treatment adherence among patients with CKD undergoing hemodialysis. Longitudinal studies are needed to clarify causal relationships.