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Abstract:
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The role of depression in non-adherence to outpatient HD treatment schedules remains
unclear and requires further investigation. This study focused on adherence to the
treatment schedule, specifically, missed and shortened outpatient HD treatments and the
potential relationship between depression and non-adherence to the treatment schedule. The study involved screening with the Beck Depression Inventory-LI (BDI-II) to measure
participant levels of depression. Additionally, a chart review was included to tally the
total number of non-adherent missed treatment minutes and record other participant
information including age, gender, ethnicity, insurance status, medical history,
medications, and length of time as a hemodialysis patient was recorded. Participants who missed no treatment time due to non-adherence had significantly lower
BDI-II scores than those who missed 100 minutes or more due to non-adherence.
Further, no significant differences involving depression and non-adherence were found
with respect to gender or ethnicity. Older participants were more adherent than younger
participants. Participants with neither hypertension nor diabetes had lower levels of
depression than those who had one or both of those co-morbidities. Frequently noted
non-somatic depressive symptoms included suicidal ideation, self-dislike, worthlessness,
and decreased enjoyment of activities that they previously enjoyed. Nephrology nurses
must intervene through close nurse/patient relationships, recognition of depressive
symptoms, screening, and referrals to appropriate mental health professionals. |
