EFFECT OF SELF-CARE INTERVENTIONS ON ADHERENCE OF GERIATRIC PATIENTS UNDERGOING HEMODIALYSIS WITH THE THERAPEUTIC REGIMEN

Abstract

Background: End-stage renal disease (ESRD) is being increasingly recognized as a serious global health problem contributing towards double burden for both the individual and the society. It is frequently associated with disturbance in the adherence behaviors with the therapeutic regimen among the geriatric patients undergoing hemodialysis (HD). This triggers the initiation of self-care management which signifies the core skills, strategies, and approaches geriatric patients apply in their care to change unhealthy behaviors, improve capabilities, better outcome, and reduce utilization of health care services.

Aim: Determine the effect of self-care interventions on adherence of geriatric patients undergoing hemodialysis to the therapeutic regimen.

Materials and Method: The study was carried out at two health care settings rendering hemodialysis services in Alexandria namely: the hemodialysis units of the Medical Research Institute and Sharq El Madina hospital which are affiliated to Alexandria University and the Ministry of Health and Population respectively. Using the convenient method, thirty-four (34) geriatric patients aged 60 years and above, undergoing hemodialysis for at least 6 months were selected from each of the previously mentioned settings in Alexandria.

Tools: Four tools were used for data gathering; Mini Mental State Examination (MMSE) Scale, Geriatric Depression Scale Short-Form (GDS-SF), Hemodialysis Geriatric Patients' Socio–Demographic and Clinical Data Structured Interview Schedule, and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ).

Results: The mean scores for adherence to the therapeutic regimen have improved significantly after the implementation of the self-care interventions, immediately and after 6 weeks.

Recommendations: Preparation of an instructional booklet and posters including the self-care interventions of ESRD must be distributed to all HD units. An Educational centre in hospitals where geriatric patients attend for dialysis must be established. These must be equipped with the necessary materials, and audio-visual aids in order to help increase patients’ knowledge about their condition. The patient can be involved in the management of their disease to improve their adherence to their therapeutic regimen.