Statement of the Problem
This study aimed to determine the level of compliance of end-stage renal disease (ESRD) patients on hemodialysis in Vicente Sotto Memorial Medical Center (VSMMC), Cebu City. It sought to identify the following: the profile of respondents in terms of intrinsic factors which included age, educational attainment, economic status, impact of disease, motivation, locus of control, and individual coping; patients' family profile in terms of extrinsic factors which included family social support and family coping; the level of compliance of ESRD patients on hemodialysis; and the significant relationship between the level of compliance on hemodialysis and intrinsic and extrinsic factors.
Correlational research design was utilized in this study. Hemodialysis Unit of the Renal Center of Vicente Sotto Memorial Medical Center (VSMMC), Cebu City was the setting. Stratified purposive sampling was the approach to obtain the respondents. Thirty-five (35) ESRD patients admitted in the Hemodialysis Unit of the Renal Center of VSMMC undergoing hemodialysis for at least three months, who were adults (ages 21 to 60) and elderly (over the age of 65) were the respondents. They were prescribed to undergo lifetime weekly hemodialysis, three sessions per week for a duration of 3 to 4 hours per session.
Standardized questionnaires used were: Client Motivation for Therapy Scale (CMOTS, Luc G. Pelletier et al.), Multidimensional Health Locus of Control Scales (MHLC, Kenneth A. Wallston), Social Support Index (SSI, Hamilton McCubbin et al.), and Family Crisis Oriented Personal Evaluation Scales (F-COPES, Hamilton I. McCubbin et al.). Researcher-made questionnaires used were Age, Educational Attainment, Impact of Disease Scale, and Compliance on Hemodialysis Scale. Cognitive and Behavioral Coping Scale was a researcher-made questionnaire which was based from Cognitive Emotion Regulation Questionnaire (CERQ, Garnefski Kraaji and Spinhoven) and Adolescent Coping Orientation for Problem Experience (ACOPE, Joan Patterson and Hamilton McCubbin). The statistical treatments included the following: frequency, percentage, mean and median, Chi-square, Pearson's Coefficient of Correlation (r), Kendall's tau_b, Goodman & Kruskal's gamma, and Systat Statistical Software.
Summary of Findings
Most of the respondents were young adults. They had higher educational attainment. They belonged to an annual family income below poverty line. The respondents experienced moderately high impact on ESRD and hemodialysis treatment. They had moderate motivation on hemodialysis treatment. They had externality of locus of control. They had high level of individual cognitive and behavioral coping. The respondents had moderate family social support and high family coping. They had fair compliance on hemodialysis preferrably complying one-session per week since the treatment was extensively expensive.
There was no significant relationship between compliance on hemodialysis and intrinsic factors such as age, educational attainment, economic status, impact of disease, motivation, locus of control, and individual cognitive and behavioral coping. There was no significant relationship between compliance on hemodialysis and extrinsic factors such as family social support and family coping.
Compliance on hemodialysis is not influenced by the respondents' intrinsic and extrinsic factors such as age, educational attainment, economic status, impact of disease, motivation, locus of control, individual cognitive and behavioral coping, family social support, and family coping. The respondents, after their long attachment to hemodialysis treatment, had developed full awareness of their condition, undergone realistic adjustment in which, they and their families had gradually accepted the inevitable limitations, rebuilding self-efficacy while making the most of the remaining possibilities.
Organize a support group for the respondents and their families to provide them counselling and establish relevant social linkages that will facilitate better compliance on hemodialysis, recovery, adaptation and rehabilitation. Linkages with government and private agencies must be strengthened for continuous economic support to ease-out partly the financial burdens of treatment.
Nursing profession should initiate patient- family-centered care for ESRD patients and their families. Community involvement is necessary to prevent or decrease the incidence of ESRD. This requires educating the community regarding renal care, prevention of renal problems and complications, and the serious effects of ESRD and hemodialysis.
Lastly, further research relevant to this study may be conducted to understand better the quality of life ESRD on hemodialysis have that would lay out the horizon of an improved, realistic, prospective, responsive, quality and holistic nursing care.