Therapeutic Adherence among Chronic Kidney Disease Patients under Hemodialysis in Selected Hospitals of Kathmandu Valley
Introduction: Chronic Kidney Disease (CKD) is an emergent public health problem in Nepal. Hemodialysis is the best treatment for this disease to reduce morbidity and mortality. Therapeutic adherence is crucial factor that influences morbidity and mortality among patients under hemodialysis. The objective of the study was to find out the therapeutic adherence among CKD patients under hemodialysis in selected hospitals of Kathmandu valley.
Methods: Descriptive cross-sectional study design was adopted. Altogether 164 patients with CKD under hemodialysis were selected by using non-probability purposive sampling technique. Data were collected through face to face interview using structured interview schedule. Frequency, percent, mean and standard deviations were used for data analysis. Nonparametric Kruskal Wallis test and Mann Whitney U test were applied to measure the mean difference in therapeutic adherence among CKD patients under hemodialysis according to selected variables.
Results: Therapeutic adherence levels were 33.5%, 62.8% and 3.7% for good, satisfactory and unsatisfactory respectively. Concerning about hemodialysis, 92.7% respondents had good, 6.1% had satisfactory and 1.2% had unsatisfactory level of adherence to hemodialysis. Furthermore, it was found that 29.9%, 1.8 % and 87.8% respondents had good; and 59.1%, 42.1% and 9.1% had satisfactory level of adherence to diet, fluid and medicine respectively. The results showed that therapeutic adherence was statistically significant with mean difference according to sex (p=0.009), duration of hemodialysis (p=0.001), total session of hemodialysis (p=0.001) and providing health information by dietician and other hemodialysis patients (p=0.001).
Conclusion: Therapeutic adherence was found to be satisfactory but adherence to fluid intake is still unsatisfactory. It is recommended that regular education and counseling should be provided in order to increase level of therapeutic adherence.
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