Influence of Major Coping Strategies on Treatment Non-adherence and Severity of Comorbid Conditions in Hemodialysis Patients

• Published in: Journal of Korean medical science Vol. 33; no. 20; pp. e148 - 11
• Main Authors: Hwang, Hyun Chan, Kim, Hye Ri, Han, Doug Hyun, Hong, Ji Sun, Jeong, So-hee, Shin, Jung-ho, Kim, Su-Hyun, Hwang, Jin Ho, Kim, Sun Mi
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 14.05.2018; 대한의학회
• Subjects: Adaptation, Psychological; Aged; Comorbidity; Diabetes Complications - diagnosis; Emotions; Female; Hope; Humans; Male; Medication Adherence; Middle Aged; Original; Psychometrics; Renal Dialysis; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - psychology; Renal Insufficiency, Chronic - therapy; Severity of Illness Index; Surveys and Questionnaires; 의학일반; Adherence; Coping strategy; Problem-focused Coping strategy; Comorbidity; Hemodialysis
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2018.33.e148

Non-adherence and comorbidities are prevalent among hemodialysis patients and are associated with increased mortality and financial burden. We aimed to investigate the influence of major coping strategies (CSs) on non-adherence and comorbidities in hemodialysis patients. A total of 49 patients were enrolled. We collected participant data including CS measured by a Korean version of the ways of coping questionnaire (K-WCQ), comorbidities measured by age-adjusted Charlson comorbidity index (CCI), and adherence measured by the 8-item Morisky medication adherence scale (MMAS-8). Regarding major CS, 61.2% of participants reported use of support-seeking CS (SUP group), 14.3% reported use of problem-focused CS (PRO group), and 24.5% reported use of hopeful-thinking CS (HOP group). The mean MMAS-8 score was higher in the PRO group than in the HOP group ( = 0.024). The mean CCI score was lower in the PRO group than in the HOP group ( = 0.017). In the HOP group, the severity of somatic symptoms was positively correlated with the scores for the emotion-focused CS subscale ( = 0.39, = 0.029) and the hopeful-thinking CS subscale ( = 0.38, = 0.036) of the K-WCQ. The level of life satisfaction positively correlated with the score for the problem-focused CS subscale in the HOP group ( = 0.40, = 0.027). We should pay more attention to the CSs of hemodialysis patients and provide interventions that promote problem-focused CSs, especially for nonadherent patients with high comorbidity rates who mainly use a hopeful-thinking CS.