Factors Associated with the Social Support of Hemodialysis Patients

By Theodoritsi, Anastasia; Aravantinou, Maria-Eleni et al. | Iranian Journal of Public Health, October 2016 | Go to article overview

Factors Associated with the Social Support of Hemodialysis Patients


Theodoritsi, Anastasia, Aravantinou, Maria-Eleni, Gravani, Victoria, Bourtsi, Eirini, Vasilopoulou, Chrysoula, Theofilou, Paraskevi, Polikandrioti, Maria, Iranian Journal of Public Health


Introduction

Chronic kidney disease consists a major public health problem, globally that entails significant burden to patients and their families. It is expanding at an alarming rate due to the increased prevalence of diabetes and hypertension as well as to the aging of population (1).

Hemodialysis patients experience tremendous psychosocial burden, mainly attributed to the limitations imposed by the disease including fluid and diet restrictions. Additionally, other stressors that contribute to this burden are physical and cognitive impairment, failure of adherence to the therapeutic regimen, dependency upon treatment and health professionals and the fear of death (2). Though several advances have been made in understanding hemodialysis treatment however, the beneficial role of social support to hemodialysis patients is slowly being acknowledged (3,4). Social support is obviously one of the most effective ways to facilitate the long-term treatment success and patients' adjustment to illness. More in detail, high social support is associated with more effective disease management (5). This beneficial effect of social support is may be achieved through psychological, medical, and biochemical factors (5).

Social support is usually provided by family, friends, co-workers, spiritual advisors, health professionals, and members of one's community. Important elements of support are quantity of the supportive network, frequency and reciprocity of supportive interaction and type of supportive interventions (5).

Consequently, it is intriguing to ascertain the critical association between hemodialysis patients' characteristics and support, having as an ultimate goal to enhance patients' participation in the therapeutic regimen, thus improving their quality of life, in the long term.

The aim of the present study was to explore the factors associated with perceived social support of hemodialysis patients.

Methods

Study population

The sample-studied consisted of 258 hemodialysis patients at dialysis centers in Athens, Greece, from Feb 2015 to Jun 2015. This sample was a convenience sample. Criteria for including a patient in the study were: a) good comprehension of Greek language; b) undergoing hemodialysis as a method of renal replacement; and c) being above 25 yr old.

Patients who met the entry criteria were informed by the researchers verbally for the purposes of this study, then, the researcher asked for patients' written consent for participation.

Data collection was performed by the completion of a questionnaire using the interview method. The questionnaire was developed by the researchers to serve fully the purposes of the study. The data collected for each patient included: socio-demographic characteristics (e.g. gender, age, marital status, place of residence, number of children, etc.); clinical characteristics (years from first hemodialysis, frequency of hemodialysis per week, duration of hemodialysis, dialysis access cannulation, etc.); therapy characteristics (adherence to treatment guidelines, etc.); and finally, effects of illness on social life (concealing problem from society, dependency on the dialysis machine, etc.).

The study was approved by the Medical Research Ethics Committee of each dialysis center and conducted in accordance with the Declaration of Helsinki (1989) of the World Medical Association.

Social Support

To evaluate the social support of the patients the Multidimensional Scale of Perceived Social Support (MSPSS) was used. This scale has been translated and culturally adapted to the Greek standards (6).

The scale is comprised of 3 groups (sub-scales) depending on the source of support (support from significant others, family and friends). Each group of support is consisting of 4 items. These are support from family (3, 4, 8, 11); support from friends (6, 7, 9, 12) and support from significant other (1, 2, 5, 10). Each item expressing 'support' is rated at a 7-point Likert scale from 1 to 7 (varying between 'definitely no' and 'definitely yes'). …

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