An exploration of the relationship between adherence with dietary sodium restrictions and health beliefs regarding these restrictions in Irish patients receiving haemodialysis for end-stage renal disease

Abstract

Aims: To measure adherence levels with dietary restrictions in Irish patients with end-stage renal disease receiving haemodialysis and to explore the relationships between adherence with dietary sodium restrictions and health beliefs in relation to following these restrictions in this group.

Background: Non-adherence to medical regimes is an important healthcare issue and an ever-present problem, particularly in patients with a chronic illness. The literature revealed a lack of studies measuring adherence with the sodium component of the renal dietary restrictions and associated factors; despite the fact that adherence with sodium restrictions is essential to the optimal management of end-stage renal disease. Furthermore, despite increased emphasis on 'the patients' view' in healthcare no study to date has contextualised health beliefs and adherence in end-stage renal disease from an Irish perspective.

Design: A quantitative, descriptive, correlational design was employed using the Health Belief Model as a theoretical framework.

Methods: A convenience sample (n = 79) was recruited from the haemodialysis units of a large hospital. Data were collected using self-report questionnaires. Data were analysed using descriptive and correlational statistics.

Results: Non-adherence with dietary restrictions was a problem among a proportion of the sample. Greater adherence levels with dietary sodium restrictions were associated with greater 'perceived benefits' and fewer 'perceived barriers.'

Conclusion: For the Irish patient, beliefs in relation to following a low sodium diet significantly affected adherence levels with this diet. This is an important finding as delineating key beliefs, particularly key barriers, facilitates an increased understanding of non-adherence for nurses.

Relevance for clinical practice: These findings have implications for the care of patients with end-stage renal disease in that they can provide guidance in terms of developing interventions designed to improve adherence.