Nephrol Dial Transplant (2003) 18: 1869-1873
© 2003 European Renal Association-European Dialysis and Transplant Association
Dietary self-efficacy: determinant of compliance behaviours and biochemical outcomes in haemodialysis patients
1 World Health Organization, Geneva, Switzerland and 2 Division of Nephrology, 1st Department of Medicine, Medical and Health Center, University of Debrecen, Debrecen, Hungary
Correspondence and offprint request to: Dr Miklos Zrinyi, World Health Organization, 34 Avenue Blanc, 1202 Geneva, Switzerland. Email: zrinyi_m{at}freemail.hu
Background. Despite the diversity of proposed theories, researchers are still unable to fully explain dietary compliance behaviours of dialysis patients. Dietary self-efficacy, a concept less studied in dialysis, has been linked to positive compliance outcomes in the chronic illness literature. Therefore, the aim of the present research was to determine how dietary self-efficacy is related to selected biochemical markers and self-reported behavioural outcomes in haemodialysis patients.
Methods. 107 subjects participated in a cross-sectional study. Four questionnaires assessed dietary self-efficacy, compliance attitudes and behaviours, and staff–patient relationships. Laboratory outcomes were retrospectively obtained from patients’ medical records and averaged for the previous 6 months.
Results. Of the behavioural measures, only dietary self-efficacy was associated with laboratory outcomes. Dietary self-efficacy was also positively related to staff–patient relationships and to patients’ self-reported assessment of compliance behaviours. Women had greater dietary self-efficacy than men. The number of family members living with the respondent was inversely related to dietary self-efficacy.
Conclusions. Results indicated that dietary self-efficacy determined both behaviours and laboratory outcomes. Patients with greater dietary self-efficacy had lower serum potassium and weight gain, showed favourable compliance attitudes and behaviours toward prescribed regimens and fostered better relationships with staff. Based on these findings we recommend an experimental approach to clarify whether maximizing dietary self-efficacy efforts is without psychological burden to patients and whether the positive effect of increased dietary self-efficacy is maintained in long-term dialysis patients.
Keywords: compliance behaviours; dietary self-efficacy; haemodialysis; health outcomes; patient–staff relationships
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