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.