Adherence to Hemodialysis Regimen: The Role of Disease-Related Knowledge and Illness Perceptions

Introduction: Important aspects that affect the adherence of patients under hemodialysis (HD) are the patients’ knowledge and illness perceptions. Adherence to the HD regimen can play an important role in chronic kidney disease and quality of life outcomes. Aim: This study aimed to explore the levels of disease-related knowledge, illness perceptions, and adherence among patients receiving HD, and to examine the relationships among these variables. Methods: In this cross-sectional study, patients receiving HD (N=119) completed three self-administered questionnaires: The Illness Perceptions Questionnaire-Revised (IPQ-R), the Kidney Disease Questionnaire, and the Greek Simplified Medication Adherence Questionnaire (GR-SMAQ-HD) to assess illness perceptions, disease-related knowledge, and adherence, respectively. Demographic and clinical data were also recorded. The study took place in an HD Unit in the Athens region between June 2022 and September 2023. SPSS version 28.0 was used for the statistical analysis, with a significance level set at 0.05. Results: Participants had low levels of disease-related knowledge and adherence. Patients’ adherence was not statistically correlated with disease-related knowledge. Negative correlations were observed between adherence and the dimensions of the IPQ-R “Emotional Representations” (r=-0.342, p<0.001) and “Causal Representations”. Α negative effect of “Εmotional Representations” and “Causal Representations” on adherence was also observed. Men and patients who were not retired scored lower levels of adherence, whereas University Graduates had higher adherence compared with Primary School Graduates. Conclusions: An increase in disease-related knowledge of patients does not necessarily mean an increase in patients’ adherence. Some dimensions of illness perceptions may be significant predictors of non-adherence.