Christensen A J, Smith T W, Turner C W, Holman J M, Gregory M C, Rich M A
Department of Psychology, University of Utah, Salt Lake City 84112.
J Behav Med. 1992 Aug;15(4):313-25. doi: 10.1007/BF00844725.
Patient noncompliance is a pervasive problem among end-stage renal disease (ESRD) patients. Previous studies have implicated social support as an important correlate of adherence behavior in other chronic illness groups, but little research has examined this relationship in a hemodialysis population. The present study examined the main and interactive effects of social support in the family and illness-related physical impairment with regard to patient compliance in a sample of 78 hemodialysis patients. Results indicated that patients holding perceptions of a more supportive family environment exhibited significantly more favorable adherence to fluid-intake restrictions than did patients reporting less family support. Family support was not associated with adherence to dietary restrictions. The effect of family support on fluid-intake adherence was not moderated by level of physical impairment. This pattern suggests that the influence of support on adherence is more attributable to a main or direct effect, as opposed to a buffering process in the face of increased physical impairment.
患者不依从是终末期肾病（ESRD）患者中普遍存在的问题。以往研究表明，社会支持是其他慢性病群体中依从行为的重要相关因素，但很少有研究在血液透析人群中考察这种关系。本研究在78例血液透析患者样本中，考察了家庭社会支持和疾病相关身体损伤对患者依从性的主要及交互作用。结果表明，认为家庭环境更具支持性的患者，比报告家庭支持较少的患者在液体摄入限制方面表现出明显更有利的依从性。家庭支持与饮食限制的依从性无关。身体损伤程度并未调节家庭支持对液体摄入依从性的影响。这种模式表明，支持对依从性的影响更多地归因于主要或直接效应，而非面对身体损伤增加时的缓冲过程。
