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Alghamdi LS, Alonazi W. The utilization of renal dialysis: a comprehensive study in Saudi Arabia. BMC Public Health 2024; 24:1914. [PMID: 39014360 PMCID: PMC11253410 DOI: 10.1186/s12889-024-19450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Understanding the trend of utilization of renal dialysis in Saudi Arabia (SA) is fundamental as it provides a general overview of renal care. The practice of renal dialysis assists in identifying challenges, opportunities, and potential areas for improvement in the provision of the services. OBJECTIVES This research investigated the utilization of renal dialysis services in SA by exploring the number of renal dialysis centers, hemodialysis machines (HD), and peritoneodialysis patients. METHODS The dataset for this study was derived from a collaboration between the General Authority of Statistics (GaStat) and the Ministry of Health (MoH), focusing on indicators for renal dialysis centers and patients across health sectors in 2021. Analysis was conducted using MS Excel 365 and IBM SPSS Version 29, incorporating multiple regression techniques. The health sector was treated as the dependent variable. At the same time, the number of hemodialysis (HD) machines and the counts of HD and peritoneal dialysis patients were considered independent variables. RESULTS Around 275 renal dialysis centers, over 8000 HD machines, 20,440 HD patients, and 1,861 peritoneal patients were tallied from two resources. The findings revealed a negative relationship between the health sector and several renal dialysis centers and peritoneodialysis patients, as demonstrated by p < 0.05 in multiple regression analysis. CONCLUSION The number of renal dialysis centers influences the availability of HD machines, affecting the number of HD and peritoneodialysis patients. Most national patients preferred MoH over other semi-governmental and private sectors, and vice versa for non-Saudis.
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Affiliation(s)
- Loujain S Alghamdi
- Health Administration Department, College of Business Administration, King Saud University, Riyadh, Riyadh, 13242-8424, Saudi Arabia
| | - Wadi Alonazi
- Health Administration Department, College of Business Administration, King Saud University, Riyadh, Riyadh, 13242-8424, Saudi Arabia.
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Khairinisa S, Darwita RR, Maharani DA, Setiawati F. Application of the extended theory of planned behavior to predict dentist intention and behavior in providing caries preventive care for preschool children. BMC Oral Health 2023; 23:970. [PMID: 38057815 PMCID: PMC10702071 DOI: 10.1186/s12903-023-03694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Various studies show a gap between evidence-based recommendations and the preventive practice of dentists. This study aimed to create and assess an extended Theory of Planned Behavior (TPB) model on dentists' intentions to do caries preventive measures and related barriers experienced by dentists. METHODS A total of 362 general dentists from 34 Indonesian provinces were included in this study. A self-administered online questionnaire consisted of three sections: dentist characteristics and practice pattern, TPB questionnaire, and dentist perceived behavior regarding preventive care for pediatric patients. The questionnaire was distributed and the data was analyzed through structural equation modeling. RESULTS TPB's extended version is a fit and relevant model, explaining 55.3% of dentists' intentions to undertake preventive procedures and 17.8% of preventive practices. Perceived behavioral control was the most powerful predictor of intention (44.2%) and practice (8.8%), while parental barriers were the most significant barrier to provide preventive care (18.9%). CONCLUSION Extending the TPB by taking barriers from multiple stakeholders as a consideration has a higher predictive level for preventive practices. Each barrier should be addressed through oral health programs and policies, and dentists must be taught to overcome these barriers (through formal or continuing education) in order to maximize caries prevention strategies.
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Affiliation(s)
- Safira Khairinisa
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Risqa Rina Darwita
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Febriana Setiawati
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia.
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Alhamad MA, Almulhim MY, Alburayh AA, Alsaad RA, Alhajji AM, Alnajjar JS, Alhashem SS, Salah G, Al Sahlawi M. Factors Affecting Adherence to Hemodialysis Therapy Among Patients With End-Stage Renal Disease Attending In-Center Hemodialysis in Al-Ahsa Region, Saudi Arabia. Cureus 2023; 15:e46701. [PMID: 38022334 PMCID: PMC10630638 DOI: 10.7759/cureus.46701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are global health concerns, with ESRD requiring renal replacement therapy (RRT). Hemodialysis is a prevalent modality for RRT. However, access to hemodialysis is challenging for rural patients due to geographical barriers and limited nephrology services. This research aims to identify factors influencing adherence to hemodialysis sessions among rural ESRD patients, addressing travel, healthcare infrastructure, and socioeconomic factors. Materials and methods A cross-sectional study of 154 participants was conducted from July 06 to September 10, 2023 at Al-Jaber Dialysis Center in Al-Ahsa, Saudi Arabia. It included adult CKD patients on hemodialysis who were interviewed to assess factors influencing hemodialysis adherence using a structured questionnaire. Results Our study assessed hemodialysis adherence in 154 patients in Al-Ahsa, Saudi Arabia. Gender distribution was nearly equal (male = 54.5%), with the majority aged 41-60, married, and residing in downtown areas. Hypertension (43.9%) and diabetes (32.3%) were the prevalent comorbidities. Most patients received thrice-weekly dialysis (96.15%), with family cars as the primary transportation mode (55.2%). Hypertension (43.3%) and diabetic nephropathy (40.9%) were the leading causes of CKD. Approximately 26% missed dialysis, with health issues and transportation difficulties being common reasons. Notably, adherence correlated with female gender, lower education, and family car transportation mode. Social support significantly influenced adherence, highlighting its importance in maintaining hemodialysis adherence. Conclusion Our study identified various sociodemographic and dialysis-related factors influencing adherence among hemodialysis patients in the Al-Ahsa region, Saudi Arabia. Notably, factors such as gender, education level, and transportation means significantly influenced adherence. Adequate family and social support were associated with better adherence. These findings highlight the importance of tailored interventions addressing these factors to enhance hemodialysis adherence and ultimately improve patient outcomes in this population.
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Affiliation(s)
| | - Mohammed Y Almulhim
- Nephrology, King Faisal University, Al-Ahsa, SAU
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | | | | | | | - Ghassan Salah
- Nephrology, King Fahad General Hospital, Al-Ahsa, SAU
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Mirzaei-Alavijeh M, Hamzeh B, Omrani H, Esmailli S, Khakzad S, Jalilian F. Determinants of medication adherence in hemodialysis patients: a cross-sectional study based on capability-opportunity-motivation and behavior model. BMC Nephrol 2023; 24:174. [PMID: 37316774 DOI: 10.1186/s12882-023-03231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Medication adherence is a key component of successful dialysis in end-stage renal disease (ESRD). The aim of this study was to use the Capability-Opportunity-Motivation and Behavior (COM-B) model in order to identify the most important determinants of medication adherence among ESRD patients. METHODS This research was a cross-sectional design that was conducted in two steps in 2021. In the first step, COM-B components of patients undergoing hemodialysis (HD) therapy were extracted through literature review. The second step was a cross-sectional study among 260 ESRD patients referred to the dialysis unit from Kermanshah, in the west of Iran. Data was collected using a written questionnaire by interviews. The data was analyzed in SPSS version 16 software. RESULTS The mean age of respondents was 50.52 years [95% CI: 48.71, 52.33], ranged from 20 to 75 years. The mean score of medication adherence was 11.95 [95% CI: 11.64, 12.26], ranged from 4 to 20. Medication adherence is higher among patients with higher education (P = 0.009) and those who were employed (P < 0.001) and was significantly related to income (r = 0.176), while it was inversely and significantly related to the medication duration (r=-0.250). Motivation (Beta: 0.373), self-efficacy (Beta: 0.244), and knowledge (Beta: 0.116) are stronger determinants of medication adherence. CONCLUSION COM-B model can be proposed as an integrated framework in predicting medication adherence among ESRD patients. Our findings provide theory-based recommendations that can help future clinical and research decision-making for the development, implementation, and evaluation of treatment adherence interventions in Iranian ESRD patients. The use of COM-B model can provide a comprehensive explanation about medication adherence in ESRD patients. Future research should be focus on increasing motivation, self-efficacy and knowledge of Iranian ESRD patients in order to increasing medication adherence.
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Affiliation(s)
- Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamidreza Omrani
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sharareh Esmailli
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Khakzad
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Lasanthika C, Wanigasuriya K, Hettiaratchi U, Amarasekara TD, Evangeline Goonewardena CS. Psychometric Properties of an Instrument to Determine the Factors Affecting Treatment Adherence Among Patients Receiving Hemodialysis in Sri Lanka. J Patient Exp 2023; 10:23743735231151558. [PMID: 36741823 PMCID: PMC9893358 DOI: 10.1177/23743735231151558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Nonadherence is a widespread problem among patients receiving hemodialysis, while contributing factors are underexplored due to lack of a validated instrument. The study aimed to develop and validate a new disease-specific instrument determining the factors affecting treatment adherence behaviors among patients receiving hemodialysis in a Sri Lankan hospital. The content validation process using a modified Delphi technique suggested 42-item instrument with an average Item-level Content Validity Index (I-CVI) of 0.94. Subsequent principal component analysis (PCA) revealed 5 components with 17 items (patient-centered psychological and physical factors, factors associated with health care, hemodialysis therapy-related factors, socioeconomic factors, and factors associated with the continuity of the treatment), explaining 67.24% total variance. The reliability estimate based on Mislevy and Bock for each component greater than 0.8 and overall standardized Cronbach's alpha of 0.605, indicated acceptable internal consistency reliability. Root mean square residual (RMSR) and weighted root mean square residual (WRMR) indices of 0.084 and 0.059, respectively, indicated acceptable model fit. The final 17-item instrument provides a valid measure for the factors affecting treatment adherence behaviors of the patients receiving hemodialysis in a Sri Lankan hospital.
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Affiliation(s)
- Chalani Lasanthika
- Faculty of Graduate Studies, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka,Department of Nursing and Midwifery, Faculty of Allied Health
Sciences, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka,Chalani Lasanthika, Department of Nursing
and Midwifery, Faculty of Allied Health Sciences, University of Sri
Jayewardenepura, Nugegoda 10250, Sri Lanka.
| | - Kamani Wanigasuriya
- Center for Kidney Research, Faculty of Medical Sciences, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka
| | - Usha Hettiaratchi
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka
| | - Thamara Dilhani Amarasekara
- Department of Nursing and Midwifery, Faculty of Allied Health
Sciences, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka
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Bazrafshan FD, Darvizeh Z, Banijamali SS. The relationship between hemodialysis patients' treatment adherence, procrastination, and difficulty in emotion regulation: A cross-sectional study in southeast Iran. Front Psychol 2023; 13:1041912. [PMID: 36726495 PMCID: PMC9885004 DOI: 10.3389/fpsyg.2022.1041912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/22/2022] [Indexed: 01/18/2023] Open
Abstract
Background End-stage renal disease is a life-threatening condition in which patients require dialysis or kidney transplant. These patients must adhere to the treatment regimen because treatment non-adherence affects their quality of life and health. We conducted this study to predict hemodialysis patients' treatment adherence based on procrastination and difficulty in emotion regulation. Materials and methods We conducted this descriptive correlational study on 218 hemodialysis patients with chronic kidney disease. We used purposive sampling to select participants from six dialysis centers in Kerman, Sirjan, and Rafsanjan. The measuring tools included the end-stage renal disease adherence questionnaire, general procrastination scale, decisional procrastination scale, and difficulty in emotion regulation scale. We used the correlation coefficient, regression analysis, and SPSS18 to analyze data. Results Our study indicated that among the dimensions of treatment adherence, medication use had a significant, weak, and inverse relationship with general and decisional procrastination. We also found a significant, weak, and inverse relationship between attendance and general procrastination (p < 0.05 and p < 0.01). But there is no significant relationship between treatment adherence, general procrastination, and decisional procrastination (p > 0.05). Multivariate regression analysis revealed a relationship between age, the cause of kidney failure, and treatment adherence (p = 0.01 and p = 0.02). Conclusion Treatment non-adherence causes problems and complications in hemodialysis Patients, and disrupts their course of treatment. Therefore, it is necessary to identify the factors influencing non-adherence of patients undergoing hemodialysis and improve their treatment adherence, and thus their quality of life.
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