title: The effects of an individual, multistep intervention on adherence to treatment in hemodialysis patients.
abstract: OBJECTIVE
  The present study was conducted to investigate the effect of individual, multistep intervention on adherence to treatment in hemodialysis patients referred to a hemodialysis center in Shahrekord, Iran.
  
  
  METHODS
  In this interventional study, hemodialysis patients referring the center of the study were randomly assigned into two control and intervention groups (each 33). The control group received routine treatment, recommended dietary and fluid restrictions. The intervention group participated in eight individual interventional sessions accompanied routine treatment. At the beginning and the end of the study, routine laboratory tests and end-stage renal disease-adherence questionnaire were filled out for patients in both groups. The data were analyzed using Mann-Whitney and Wilcoxon tests.
  
  
  RESULTS
  At the end of the study, the two groups showed a significant difference in all domains of adherence except adherence to diet and adherence was better in the intervention group (p < 0.05). In demographic characteristic, only age indicated a positive correlation with adherence to dialysis program (p = 0.04, r = 0.254). After intervention, serum phosphorus decreased significantly in the intervention group (p < 0.05).
  
  
  CONCLUSIONS
  Adherence to treatment is one of the major problems in hemodialysis patients; however, comprehensive interventions are required in view of individual condition. Implications for Rehabilitation Adherence to treatment means that all patients' behaviors (diet, fluids and drugs intake) should be in line with the recommendations given by healthcare professionals. There is evidence on the association between adherence to treatment and decreased risk of hospitalization in dialysis patients. Individual structured programs are most likely to be successful in encouraging adherence to treatment.
authors.affiliation: a Department of Nursing , Shahrekord University of Medical Sciences , Shahrekord , Iran and.
authors.forename: Leila
authors.initials: L
authors.lastname: Rafiee Vardanjani
authors.affiliation: a Department of Nursing , Shahrekord University of Medical Sciences , Shahrekord , Iran and.
authors.forename: Neda
authors.initials: N
authors.lastname: Parvin
authors.affiliation: b Department of Nursing , Golestan University of Medical Sciences , Golestan , Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Mahmoodi Shan
keywords: Adherence to treatment; hemodialysis; nurse