ADHERENCE TO HEMODIALYSIS AND MEDICAL REGIMENS AMONG PATIENTS WITH END-STAGE RENAL DISEASE IN PALESTINE: A CROSS-SECTIONAL QUANTITATIVE MULTICENTER STUDY

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dc.contributor.authorIssa, Muneer
dc.date.accessioned2025-09-16T09:58:37Z
dc.date.available2025-09-16T09:58:37Z
dc.date.issued2025-06-24
dc.description.abstractAbstract Introduction: Chronic Kidney Disease (CKD), particularly End-Stage Renal Disease (ESRD), poses a significant public health challenge globally, with hemodialysis (HD) being a primary treatment modality. Adherence to medical regimens, dietary restrictions, and fluid management is critical for improving patient outcomes. However, adherence levels among ESRD patients vary due to multifactorial influences, including sociodemographic and health-related factors. This study aimed to assess adherence levels among Palestinian ESRD patients undergoing HD and identify associated factors. Objectives: Measure adherence rates to medications, dietary recommendations, and HD sessions among ESRD patients. Also, to identify sociodemographic and health-related factors influencing adherence. Finally, to investigate barriers to adherence, such as socioeconomic status and health literacy. Methodology: A cross-sectional quantitative study was conducted on 260 ESRD patients from three hospitals in northern West Bank, Palestine. Data were collected using the validated End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which assessed adherence to HD sessions, medications, fluid restrictions, and diet. Descriptive and analytical statistics, including Kruskal-Wallis and Mann-Whitney tests, were employed to analyze the data. Results: The majority of participants (68.5%) exhibited good adherence, with a median score of 1100 (IQR = 250). Higher adherence was significantly associated with higher educational levels (p < 0.001), ESRD due to inflammatory causes (p = 0.009), prior peritoneal dialysis (PD) (p = 0.012), and no history of kidney transplant (p = 0.033). Lower adherence correlated with higher serum potassium (r = -0.352, p < 0.001) and phosphorus levels (r = -0.330, p < 0.001). Peri-dialytic weight differences were greater among patients with higher education (p < 0.001). Conclusions: Adherence levels among Palestinian ESRD patients are influenced by educational background, disease etiology, and prior treatment modalities. Nurse-led interventions and tailored educational programs are recommended to enhance adherence, particularly for patients with lower health literacy or congenital ESRD causes. Future research should explore the impact of such interventions on long-term health outcomes. Key words: Adherence, Chronic Kidney Disease, End-Stage Renal Disease, Hemodialysis, Palestine, ESRD-AQ, Medical Regimens.
dc.identifier.urihttps://hdl.handle.net/20.500.11888/20418
dc.language.isoen
dc.publisherAn-Najah National University
dc.supervisorSaid, Nizar
dc.supervisorHayek, Mohammed
dc.titleADHERENCE TO HEMODIALYSIS AND MEDICAL REGIMENS AMONG PATIENTS WITH END-STAGE RENAL DISEASE IN PALESTINE: A CROSS-SECTIONAL QUANTITATIVE MULTICENTER STUDY
dc.title.alternativeالالتزام بالغسيل الكلوي والبرامج الطبية لدى المرضى المصابين بمرض الفشل الكلوي في فلسطين: دراسة مقطعية كمية متعددة المراكز
dc.typeThesis
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