Determinants of Adherence to Hemodialysis Treatment: A Predictive Analysis

Background: Treatment adherence in end-stage renal disease is a key component of successful hemodialysis. This study aims to identifying the factors that determine treatment adherence among hemodialysis patients in Telafer city.

Methods: This cross-sectional study of sixty hemodialysis patients was conducted from September 2024 to May 2025 in the dialysis center of Telafer city, Nineveh governorate, Iraq.  Study Data were collected by a specialized questionnaire consisting of the End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ) and TPB constructs scale. The Statistical Package for Social Sciences (SPSS) software for Windows version 26 were used to analyze descriptive and inferential statistics.

Results: The study shown that the mean age of participants is (49.75±17.87). Regarding TPB constructs, the result demonstrates that the mean score of attitudes is (34.93±2.61), perceived subjective norms is (21.75±1.38), perceived behavioral control is (30.00±1.61), and intention to hemodialysis is (7.86±0.79). The finding of the study demonstrated that four factors (knowledge, subjective norms, perceived behavioral control and intention) are determine treatment adherence(P<0.05). The odds ratio for these factors was ₌ 1.214; 95% CI (1.061-1.431), 1.658; 95% CI (1.045-2.903), 1.214; 95% Cl (0.804-1.86) and 0.957; 95% Cl (0.45-2.019) respectively. Path analysis of TPB constructs indicated that (38%) of the variance in intention could be explained by perceived subjective norms and perceived behavioral control.  Also, (65%) of the variance in adherence can be explained by intention.

Conclusion: This study presented that knowledge about hemodialysis, perceived Subjective norms, perceived Behavioral control and intention are factors that predict adherence to hemodialysis treatment.