title: Health care providers' support of patients' autonomy, phosphate medication adherence, race and gender in end stage renal disease.
abstract: This study was designed to assess dialysis subjects' perceived autonomy support association with phosphate binder medication adherence, race and gender. A multi-site cross-sectional study was conducted among 377 dialysis subjects. The Health Care Climate (HCC) Questionnaire assessed subjects' perception of their providers' autonomy support for phosphate binder use, and adherence was assessed by the self-reported Morisky Medication Adherence Scale. Serum phosphorus was obtained from the medical record. Regression models were used to examine independent factors of medication adherence, serum phosphorus, and differences by race and gender. Non-white HCC scores were consistently lower compared with white subjects' scores. No differences were observed by gender. Reported phosphate binder adherence was associated with HCC score, and also with phosphorus control. No significant association was found between HCC score and serum phosphorus. Autonomy support, especially in non-white end stage renal disease subjects, may be an appropriate target for culturally informed strategies to optimize mineral bone health.
authors.affiliation: Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue MCN S-3223, Nashville, TN, 37232, USA.|Vanderbilt Center for Kidney Disease, Nashville, TN, USA.
authors.forename: Ebele M
authors.initials: EM
authors.lastname: Umeukeje
authors.affiliation: School of Social Work, University of Minnesota, Saint Paul, MN, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Merighi
authors.affiliation: College of Social Work, University of South Carolina, Columbia, SC, USA.
authors.forename: Teri
authors.initials: T
authors.lastname: Browne
authors.affiliation: Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue MCN S-3223, Nashville, TN, 37232, USA.|Vanderbilt Center for Kidney Disease, Nashville, TN, USA.
authors.forename: Marcus
authors.initials: M
authors.lastname: Wild
authors.affiliation: Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Hafez
authors.initials: H
authors.lastname: Alsmaan
authors.affiliation: Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Kausik
authors.initials: K
authors.lastname: Umanath
authors.affiliation: Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue MCN S-3223, Nashville, TN, 37232, USA.|Vanderbilt Center for Kidney Disease, Nashville, TN, USA.
authors.forename: Julia B
authors.initials: JB
authors.lastname: Lewis
authors.affiliation: Vanderbilt University School of Nursing, Nashville, TN, USA.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.affiliation: Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue MCN S-3223, Nashville, TN, 37232, USA. kerri.cavanaugh@vanderbilt.edu.|Vanderbilt Center for Kidney Disease, Nashville, TN, USA. kerri.cavanaugh@vanderbilt.edu.
authors.forename: Kerri L
authors.identifier: http://orcid.org/0000-0002-4031-1714
authors.initials: KL
authors.lastname: Cavanaugh
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D010758:Phosphorus / Q000097:blood; D057566:Self Report; D012737:Sex Factors
chemical_list: D010758:Phosphorus
keywords: Autonomy support; Bone mineral disorder; Dialysis; Gender; Medication adherence; Race; Self-determination theory