Inverse Correlation Between Recovery Time with Adherence to Hemodialysis Treatment Regimens and Self-Management in Indonesian Patients on Long-Term Hemodialysis

Background: Patients on chronic hemodialysis (CHD) often complain of unpleasant post-dialysis symptoms and require recovery time (RT) before resuming their usual activities. Studies have shown numerous factors influence RT after dialysis, including adherence to hemodialysis treatment regimens (HTR). Studies have also identified that non-adherence to HTR was caused by poor patient self-management (SM). There is limited data about the time to recover (TTR) after dialysis in Indonesia. The present study was designed to analyse the relationship between adherence to HTR with RT. The correlation between SM on adherence to HTR and RT was also determined in this study. Methods: This study was performed in the hemodialysis unit of Haji Adam Malik Hospital; a tertiary hospital of North Sumatera, Indonesia. All CHD patients for at least twelve consecutive weeks with age ≥18 years, were asked the question, “How long does it take to recover after dialysis”? Patients who were not able to respond appropriately to the question were excluded from the study. Reported TTR after dialysis was classified as <1 h, 1–4 h and >4 h. All patients were asked to complete the End Stage Renal Disease Adherence Questionnaire to measure adherence to HTR and the Hemodialysis Self Management Instrument-18 to asses patient SM. Results: The mean age of the study population was 49,98 ± 14,41 years. Among the 79 patients, 53 (67.1%) were males. The mean dialysis vintage was 1,46 ± 1,23 years. Thirty-eight patients (48.1%) reported a TTR after dialysis <1 h; 40 patients (50.6%) reported RT between 1–4 h and 1 patient (1.3%) reported a TTR after dialysis >4 h. RT after dialysis inversely correlated with patient’s SM (r = -0,811) and adherence to HTR (r = -0,789) scores which were statistically significant (p < 0,001). Patient SM was statistically significant (p <0,001) and positively correlated with adherence to HTR (r = +0,736) scores. Conclusion: The present study provides evidence for an inverse correlation between the TTR after dialysis with adherence to HTR and patient SM. Patients with good SM had good adherence to HTR. Interventions to increase adherence to HTR and educational programs for SM need to be done in Indonesian CHD patients to reduce the TTR after dialysis.