Hedayati Pari, Shahgholian Nahid, Ghadami Ahmad
Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Critical Care Nursing, Kidney Diseases Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2017 Mar-Apr;22(2):97-101. doi: 10.4103/ijnmr.IJNMR_220_15.
Kidney transplantation is the renal replacement therapy of choice for most patients with end-stage renal disease (ESRD), however, adherence to the recommended lifestyle is critical for a positive prognosis. The purpose of this study was to assess adherence to immunosuppressive therapy and lifestyle recommendations along with some related factors among kidney transplant patients.
In this descriptive analytical study, all patients completed a questionnaire regarding medication intake and lifestyle recommendations (preventing of infection, self-monitoring, prevention of cardiovascular disease (CVD), and sun protection). The participants were divided into 4 groups according to the level of adherence (good, partial, poor, and nonadherent) indicated in their responses.
Most kidney recipients were adherent to their drug prescriptions, but were partial, poor, or nonadherent regarding lifestyle recommendations. Increased passage of time since transplantation and low family support and educational level resulted in nonadherence. Men showed greater adherence to medication intake than women. Patients with lower number of drugs and reported drug side-effects illustrated better adherence to medication intake. Women adhered to infection protection recommendations more than men, and older and married patients adhered to cardiovascular prevention recommendations more than others. However, younger patients showed greater adherence to self-monitoring recommendations, and singles, young individuals, and women were adherent to sun protection recommendations.
Nonadherence is common among kidney transplant recipients. Thus, it is necessary to determine patients who are at risk of nonadherence and to introduce more educational programs to improve their adherence and their quality of life (QOL).
肾移植是大多数终末期肾病(ESRD)患者首选的肾脏替代治疗方法,然而,坚持推荐的生活方式对于良好的预后至关重要。本研究的目的是评估肾移植患者对免疫抑制治疗和生活方式建议的依从性以及一些相关因素。
在这项描述性分析研究中,所有患者都完成了一份关于药物摄入和生活方式建议(预防感染、自我监测、预防心血管疾病(CVD)和防晒)的问卷。根据患者回答中显示的依从性水平(良好、部分、差和不依从)将参与者分为4组。
大多数肾移植受者坚持服用药物处方,但在生活方式建议方面存在部分、差或不依从的情况。移植后时间增加、家庭支持少和教育水平低导致不依从。男性在药物摄入方面的依从性高于女性。药物数量较少且报告有药物副作用的患者在药物摄入方面的依从性更好。女性在感染防护建议方面的依从性高于男性,年龄较大和已婚患者在心血管预防建议方面的依从性高于其他人。然而,年轻患者在自我监测建议方面的依从性更高,单身、年轻个体和女性在防晒建议方面的依从性较好。
不依从在肾移植受者中很常见。因此,有必要确定有不依从风险的患者,并引入更多教育项目以提高他们的依从性和生活质量(QOL)。