title: Family support, physical impairment, and adherence in hemodialysis: an investigation of main and buffering effects.
abstract: Patient noncompliance is a pervasive problem among end-stage renal disease (ESRD) patients. Previous studies have implicated social support as an important correlate of adherence behavior in other chronic illness groups, but little research has examined this relationship in a hemodialysis population. The present study examined the main and interactive effects of social support in the family and illness-related physical impairment with regard to patient compliance in a sample of 78 hemodialysis patients. Results indicated that patients holding perceptions of a more supportive family environment exhibited significantly more favorable adherence to fluid-intake restrictions than did patients reporting less family support. Family support was not associated with adherence to dietary restrictions. The effect of family support on fluid-intake adherence was not moderated by level of physical impairment. This pattern suggests that the influence of support on adherence is more attributable to a main or direct effect, as opposed to a buffering process in the face of increased physical impairment.
authors.affiliation: Department of Psychology, University of Utah, Salt Lake City 84112.
authors.forename: A J
authors.initials: AJ
authors.lastname: Christensen
authors.forename: T W
authors.initials: TW
authors.lastname: Smith
authors.forename: C W
authors.initials: CW
authors.lastname: Turner
authors.forename: J M
authors.initials: JM
authors.lastname: Holman
authors.forename: M C
authors.initials: MC
authors.lastname: Gregory
authors.forename: M A
authors.initials: MA
authors.lastname: Rich
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D003928:Diabetic Nephropathies / Q000523:psychology / Q000628:therapy; D005190:Family / Q000523:psychology; D005260:Female; D006437:Hemodialysis, Home / Q000523:psychology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D016030:Kidney Transplantation / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology*; D012803:Sick Role; D012931:Social Environment; D012944:Social Support