The association of illness perception and related factors with treatment adherence among chronic hemodialysis patients with cardio-renal syndrome in Yemen

Abstract

Background: Patients' illness perceptions are cognitive representations or beliefs structured around their condition. These perceptions have been associated with several important outcomes, including functional recovery and treatment adherence.

Objective: The aim of this study was to investigate the association between illness perception and related factors with treatment adherence among hemodialysis patients with cardio-renal syndrome in Yemen.

Methods: This cross-sectional study was conducted at two dialysis centers in Hadhramout Governorate, Yemen, from February to May 2021. Three self-administered questionnaires were used to collect the data. Data analysis was performed using SPSS version 23.0 with a significance level set at p < 0.05.

Results: In total, 100 patients answered all questions with a total response rate of 100%. The mean age ± standard deviation of participants was 53.46 ± 14.24 years. Most patients (87%) had a low level of treatment adherence, particularly in medication and diet restriction adherence. Furthermore, most patients (90%) had a moderate-to-high level of perceived illness threat. The findings revealed no significant correlation between overall illness perception and overall treatment adherence (r = 0.003, p = 0.975). However, the perceived consequences (r = -0.210, p < 0.05), and perceived timeline subscales (r = -0.276, p < 0.01) showed a negative correlation with total treatment adherence. Additional findings revealed a significant positive link between adherence and cardiac disorders (β = 4.292, p = 0.009), as well as a strong correlation between adherence and income level (β = 11.132, p < 0.001).

Conclusions: Our research found that most patients with cardio-renal syndrome had poor treatment adherence and had a moderate-to-high level of perceived illness threat. The results of the study showed that perceived consequences and perceived timeline subscales of illness perceptions had a negative correlation with overall treatment adherence, and the results revealed a significant positive link between adherence and cardiac disorders, as well as a strong correlation between adherence and income level. The findings suggest that nurses and clinicians should assess the illness perceptions specific to patients with cardio-renal syndrome disease when developing multidisciplinary interventions to help patients cope with and manage different aspects of their condition.

Keywords: Yemen; cardio-renal syndrome; hemodialysis; illness perception; treatment adherence.