PSYCHOSOCIAL AND DEMOGRAPHIC ASPECTS OF NON-COMPLIANCE IN CHRONIC HEMODIALYSIS PATIENTS

THE AIM of the investigation was to determine psychosocial, demographic and clinicalbiochemical factors influencing non compliance of hemodialysis patients. PATIENTS AND METHODS. Under examinations there were 51 patients on chronic hemodialysis (HD). The excessive gaining of weight of the patients in the periods between dialysis procedures, absence from the procedures, and shortening the HD sessions were used as indices of noncompliance. Smoking and alcohol abuse were analyzed along with traditional indices of noncompliance. Psychodiagnostic techniques were used for the assessment of depression, anxiety, personal peculiarities, life quality, life aims and value orientations of the patients. RESULTS. Only stricter criteria of noncompliance (relative gaining weight over 5.7% of the patient’s dry weight, absence from and shortening HD sessions more than once a month) included about one third of the patients into the group of noncompliance patients even if by one index. However if the group of undisciplined patients could include all patients with weight gain more than 3 kg in the period between the HD sessions, the group of non compliance would include more than half patients. It was shown that smoking, alcohol abuse and all other indices of noncompliance are closely interconnected. Younger age of the patients (p=0.004) was found to be reliably connected with noncompliance. The rank correlation and factor analyses have shown that noncompliance is associated with such features as mistrustfulness, nonobservance of social norms, independence, low selfcontrol, emotional instability, external locus of control, dissatisfaction with selfrealization, absence of life perspectives. No reliable relationships of noncompliance indicators with gender, education, job, family, social supporting, mental state of the patient, life quality, clinicalbiochemical and anamnestic indices were revealed. CONCLUSION. It was found that the factors predisposing to noncompliance are young age, «somatic safety» and unfavorable personal features.

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