title: Rates of Intentional and Unintentional Nonadherence to Peritoneal Dialysis Regimes and Associated Factors.
abstract: With increasing emphasis on expanding home-based dialysis, there is a need to understand adherence outcomes. This study set out to examine the prevalence and predictors of nonadherence among patients undergoing peritoneal dialysis. A cross sectional sample of 201 peritoneal dialysis patients recruited between 2010-2011 from Singapore General Hospital completed measures of quality of life, medication beliefs, self-efficacy and emotional distress. Nonadherence rates were high; 18% for dialysis, 46% for medication and 78% for diet. Intentional nonadherence was more common for dialysis (p = .03), whereas unintentional nonadherence was more common for medication (p = .002). Multivariate models indicated significant associations for higher education (intermediate vs low OR = 3.18, high vs low OR = 4.70), lower environment quality of life (OR = 0.79), dialysis self-efficacy (OR = 0.80) with dialysis nonadherence; higher education (OR = 2.22), self-care peritoneal dialysis (OR = 3.10), perceived necessity vs concerns over medication (OR = 0.90), self-efficacy (OR = 0.76) with nonadherence to medication. The odds for nonadherence to diet were higher among patients who were younger (OR = 0.96), of Chinese ethnicity (OR = 2.99) and those reporting better physical health (OR = 1.30) and lower self-efficacy (OR = 0.49). Nonadherence is common in peritoneal dialysis. Self-efficacy and beliefs about medication are promising targets for interventions designed to improve adherence.
authors.affiliation: Department of Psychology, National University of Singapore, Singapore, Singapore.
authors.forename: Zhen Li
authors.initials: ZL
authors.lastname: Yu
authors.affiliation: Department of Psychology, National University of Singapore, Singapore, Singapore.
authors.forename: Vanessa Yin Woan
authors.initials: VY
authors.lastname: Lee
authors.affiliation: Department of Psychology, National University of Singapore, Singapore, Singapore.
authors.forename: Augustine Wee Cheng
authors.initials: AW
authors.lastname: Kang
authors.affiliation: Alice Lee Centre for Nursing Studies, National University Hospital, Singapore, Singapore.
authors.forename: Sally
authors.initials: S
authors.lastname: Chan
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Foo
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: Choong Meng
authors.initials: CM
authors.lastname: Chan
authors.affiliation: Department of Psychology, National University of Singapore, Singapore, Singapore.|Health Services Research Group, City University London, London, United Kingdom.
authors.forename: Konstadina
authors.initials: K
authors.lastname: Griva
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010530:Peritoneal Dialysis / Q000523:psychology / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012846:Singapore; D013315:Stress, Psychological / Q000523:psychology