Adherence to hemodialysis dietary sodium recommendations: influence of patient characteristics, self-efficacy, and perceived barriers.
OBJECTIVE
To identify characteristics of hemodialysis patients most likely to experience difficulty adhering to sodium restrictions associated with their dietary regimen.


METHODS
Secondary analysis using baseline data from an ongoing randomized clinical trial examining the effects of a technology-supported behavioral intervention on dietary sodium intake in hemodialysis patients.


METHODS
Thirteen dialysis centers in southwestern Pennsylvania.


METHODS
We included 122 participants (61% women; 48% African American) aged 61 ± 14 years undergoing maintenance, intermittent hemodialysis for end-stage renal disease.


METHODS
Normalized dietary sodium intake, adjusted interdialytic weight gain, perceived problems, and self-efficacy for restricting dietary sodium.


RESULTS
Younger participants were more likely to report problems managing their hemodialysis diet and low self-efficacy for restricting sodium intake. Consistent with these findings, younger participants had a higher median sodium intake and higher average adjusted interdialytic weight gain. Females reported more problems managing their diet. Race, time on dialysis, and perceived income adequacy did not seem to influence outcome measures.


CONCLUSIONS
Our findings suggest that patients who are younger and female encounter more difficulty adhering to the hemodialysis regimen. Hence, there may be a need to individualize counseling and interventions for these individuals. Further investigation is needed to understand the independent effects of age and gender on adherence to hemodialysis dietary recommendations and perceived self-efficacy.
Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: mayan@nursing.upenn.edu.
Maya N
MN
Clark-Cutaia
Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, Pennsylvania.
Dianxu
D
Ren
Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, Pennsylvania.
Leslie A
LA
Hoffman
Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, Pennsylvania.
Lora E
LE
Burke
Medicine, Public Health, Clinical and Translational Science, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; and Nursing Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania.
Mary Ann
MA
Sevick
D001741:Black or African American; D000368:Aged; D004032:Diet; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010414:Pennsylvania; D064167:Recommended Dietary Allowances; D006435:Renal Dialysis; D020377:Self Efficacy; D012959:Socioeconomic Factors; D012982:Sodium, Dietary / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D015430:Weight Gain; D044465:White People
D012982:Sodium, Dietary