Association between health-related hope and adherence to prescribed treatment in CKD patients: multicenter cross-sectional study

BMC Nephrology

Shunichi Fukuhara¹  Noriaki Kurita²  Yoshitaka Ishibashi³  Mai Yanagi³  Shino Fujimoto³  Takafumi Wakita⁴  Kenichiro Koitabashi⁵  Masahiko Yazawa⁵  Yugo Shibagaki⁵  Hiroo Kawarazaki⁶  Tomo Suzuki⁷  Joseph Green⁸ 

[1] Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan;Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan;Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan;Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan;Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, 960-1295, Fukushima, Japan;Department of Nephrology, Japanese Red Cross Medical Center, Tokyo, Japan;Department of Sociology, Kansai University, Osaka, Japan;Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan;Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan;Department of Nephrology, Inagi Municipal Hospital, Tokyo, Japan;Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan;Department of Nephrology, Kameda Medical Center, Chiba, Japan;Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;

关键词: Adherence;    Diet restriction;    Fluid restriction;    Chronic kidney disease;    Health-related hope;    Blood pressure;    Dialysis;    Quality of life;   

DOI  :  10.1186/s12882-020-02120-0

来源: Springer

【 摘 要 】

BackgroundIn chronic kidney disease (CKD), patients’ adherence to prescriptions for diet and for medications might depend on the degree to which they have hope that they will enjoy life, and that hope could vary with the stage of CKD. The aims of this study were to quantify both the association of CKD stage with health-related hope (HR-Hope), and the association of that hope with psychological and physiological manifestations of adherence.MethodsThis was a cross-sectional study involving 461 adult CKD patients, some of whom were receiving dialysis. The main exposure was HR-Hope, measured using a recently-developed 18-item scale. The outcomes were perceived burden of fluid restriction and of diet restriction, measured using the KDQOL, and physiological manifestations of adherence (systolic and diastolic blood pressure [BP], and serum phosphorus and potassium levels).General linear models and generalized ordered logit models were fit.ResultsParticipants at non-dialysis stage 4 and those at stage 5 had lower HR-Hope scores than did those at stage 2 or 3 (combined). Those at non-dialysis stage 5 had the lowest scores. HR-Hope scores of participants at stage 5D were similar to those of participants at stage 4, but they were lower than the scores of participants at stage 2 or 3 (combined). Higher HR-Hope scores were associated with lower perceived burdens of fluid restriction and of diet restriction (adjusted ORs per ten-point difference were 0.82 and 0.84, respectively). Higher HR-Hope scores were associated with lower systolic BP (adjusted mean difference in systolic BP per ten-point difference in HR-Hope scores was − 1.87 mmHg). In contrast, HR-Hope scores were not associated with diastolic BP, serum phosphorus levels, or serum potassium levels.ConclusionsAmong CKD patients, HR-Hope is associated with disease stage, with psychological burden, and with some physiological manifestations of adherence.

【 授权许可】

CC BY