Factors Influencing Dietary Adherence as Perceived by Patients on Long-term Intermittent Peritoneal Dialysis

Abstract

One of the many adaptive tasks of the individual with a chronic illness is the management of a medical regimen. Nonadherence to prescribed health regimens is a familiar problem to health professionals. The complex and demanding regimen of the person with end-stage renal disease (ESRD) usually includes dietary modifications designed to supplement dialysis in alleviating the physiological imbalance of impaired kidney function. While some patients on home dialysis programs may require little dietary restriction, those on intermittent hospital schedules usually have a prescribed intake of protein, sodium, potassium and fluid. Studies on dietary adherence in dialysis populations (Blackburn, 1977; DeNour & Czaczkes, 1972; Hartman & Becker, 1978; Procci, 1978) indicate that nonadherence is a significant problem. The ongoing contact between patients on hospital maintenance dialysis programs and the dialysis team provides team members with the opportunity to assist these patients in making the required behavioural changes. Although adaptation to hemodialysis has been studied extensively, there is still little reliable information on the factors influencing dietary adherence in dialysis patients, especially those on peritoneal dialysis programs. Such information would assist nurses and other health workers in planning appropriate interventions.