Browsing School, Graduate by Title "Quality of life, perceived social support and adherence to fluid restriction and treatment schedule among hemodialysis patients"
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Quality of life, perceived social support and adherence to fluid restriction and treatment schedule among hemodialysis patientsIssues of quality-of-life and social support are important to nephrology social workers in delivering psychological and concrete services to dialysis patients. However, the patients are often non-compliant with a restriction of fluid gain and their regular treatment schedules. The result of this non-adherence is likely to be excess weight gain leading to hospitalization or even death from pulmonary edema and/or congestive heart failure. There were two aims of the study. One was to associate measures of compliance to both fluid restriction and adherence to treatment schedules with quality-of-life measures, as operationalized by the Medical Outcomes Study SF-36 scales. Secondly, the study sought to examine whether social support was independently associated with quality-of-life or whether it would buffer the ill effects of fluid gain. The hypotheses also tested the association between quality-of-life and social support while controlling for compliance measures. Social support was measured by two instruments, an existing perceived social support scale, and another similar instrument designed by the author. A pilot test of the latter, the Perceived Social Support-Dialysis Scale, yielded a high alpha coefficient (.81). The construct of social support was also confirmed in a LISREL analysis. Fluid-gain data were recorded from patients' charts. The sample consisted of fifty-eight hemodialysis outpatients from an inner-city dialysis site in Baltimore. After correcting for multiple statistical tests, none of the hypothetical associations was supported in the regression analyses although some associations were close to significance. Explanations for lack of positive findings and an interpretation of trends, including a discussion of the potential usefulness of the dialysis social support instrument are addressed. For example, it was noted that the associations between age and the SF-36 scales, while not truly significant, indicated a trend of decreased quality-of-life with age.