Knowledge, attitude and barriers to self-care management among patients with chronic kidney disease undergoing hemodialysis at Muhimbili National Hospital, in Dar es salaam, Tanzania

Abstract

Background Chronic kidney disease (CKD) is a major global health concern, affecting approximately 10% of the population. Patients undergoing hemodialysis face significant challenges related to disease progression and treatment demands, necessitating both self-care and clinical support. However, limited data exist on CKD patients' knowledge, attitudes, and self-care barriers, particularly in low-resource settings like Tanzania. This study assessed these factors among hemodialysis patients at Muhimbili National Hospital (MNH). Methods A descriptive cross-sectional study was conducted among 240 hemodialysis patients at MNH using a simple random sampling technique. Data were collected through interviewer-administered structured questionnaires and analyzed using SPSS version 25. Bivariate analysis identified associations between variables, followed by multivariable logistic regression to determine independent predictors of self-care management. Results The mean (±SD) age of participants was 48.6 (±11.51) years. Overall, 47.1% demonstrated adequate knowledge, while 69.6% exhibited positive attitudes toward self-care. Participants without formal education were significantly less likely to have adequate self-care knowledge (AOR 0.366, 95% CI 0.148-0.821, p=0.038). Single participants were more likely to have a positive attitude compared to divorced individuals (AOR 4.953, 95% CI 0.741-33.124, p=0.044). Strict medication schedules and lifestyle modifications were the main barriers to self-care. Conclusion Significant knowledge gaps exist among hemodialysis patients, influenced by education level and prior health education. Tailored interventions and provider support are crucial for overcoming barriers and improving self-care in resource-limited settings.