Self-motivation, family support, and hemodialysis adherence among patients with chronic kidney disease
DOI: https://doi.org/10.56922/msc.v6i2.2998
Chronic Kidney Disease Family Support Hemodialysis Self-Motivation Treatment Adherence
Abstract
Background: Maintenance hemodialysis requires sustained adherence to treatment schedules, medication, dietary recommendations, and fluid restrictions. Adherence may be influenced by patients' internal motivation and the support available within the family.
Purpose: To examine the associations of self-motivation and family support with hemodialysis therapy adherence among patients with chronic kidney disease.
Method: This cross-sectional study included 143 patients receiving maintenance hemodialysis at two hospitals in Tangerang, Indonesia. Participants were recruited through total sampling from September to November 2025. Self-motivation, family support, and treatment adherence were assessed using structured questionnaires. Associations were analyzed using Spearman's rank correlation test.
Results: Low self-motivation was the largest category, reported by 53 participants (37.1%), and low family support was reported by 51 participants (35.7%). Regarding adherence, 53 participants (37.1%) were partially adherent and 48 (33.6%) were non-adherent. Self-motivation (ρ = 0.611, p < 0.001) and family support (ρ = 0.607, p < 0.001) each showed a strong positive correlation with hemodialysis adherence.
Conclusion: Higher self-motivation and stronger family support were associated with greater adherence to hemodialysis therapy. Nursing strategies that strengthen patient engagement and involve family members may support adherence to long-term treatment.
Downloads
References
Alatawi, A. A., Alaamri, M., & Almutary, H. (2024, October). Social support and adherence to treatment regimens among patients undergoing hemodialysis. In Healthcare (Vol. 12, No. 19, p. 1958). MDPI.
Almutary, H., & Tayyib, N. (2021). Evaluating self-efficacy among patients undergoing dialysis therapy. Nursing Reports, 11(1), 195-201.
Asih, E. Y., & Aji, Y. G. T. (2022). Gambaran Kualitas Hidup Pasien Dengan Penyakit Ginjal Kronik Yang Menjalani Hemodialisis Di RSAU dr. Esnawan Antariksa. Jurnal Kesehatan Mahardika, 9(2), 29-36.
Griva, K., Nandakumar, M., Jo-an, H. N., Lam, K. F., McBain, H., & Newman, S. P. (2018). Hemodialysis self-management intervention randomized trial (HED-SMART): a practical low-intensity intervention to improve adherence and clinical markers in patients receiving hemodialysis. American Journal of Kidney Diseases, 71(3), 371-381.
Hosseini, A., Jackson, A. C., Chegini, N., Dehghan, M. F., Mazloum, D., Haghani, S., & Bahramnezhad, F. (2023). The effect of an educational app on hemodialysis patients’ self-efficacy and self-care: A quasi-experimental longitudinal study. Chronic illness, 19(2), 383-394.
Hou, Y., Li, L., Zhou, Q., Wang, G., & Li, R. (2022). Relationships between social capital, patient empowerment, and self-management of patients undergoing hemodialysis: a cross-sectional study. BMC nephrology, 23(1), 71.
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., & Levin, A. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney international, 105(4), S117-S314.
Kim, H., & Cho, M. K. (2021). Factors influencing self-care behavior and treatment adherence in hemodialysis patients. International journal of environmental research and public health, 18(24), 12934.
Ma, L. C., Liu, Y. M., Lin, Y. C., Liao, C. T., Hung, K. C., Chen, R., & Zheng, C. M. (2022). Factors influencing self-management behaviors among hemodialysis patients. Journal of personalized medicine, 12(11), 1816.
Natashia, D., Yen, M., Chen, H. M., & Fetzer, S. J. (2019). Self‐management behaviors in relation to psychological factors and interdialytic weight gain among patients undergoing hemodialysis in Indonesia. Journal of Nursing Scholarship, 51(4), 417-426.
Ozen, N., Cinar, F. I., Askin, D., Mut, D., & Turker, T. (2019). Nonadherence in hemodialysis patients and related factors: a multicenter study. Journal of Nursing Research, 27(4), e36.
Pasyar, N., Rambod, M., & Jowkar, M. (2020). The effect of peer support on hope among patients under hemodialysis. International journal of nephrology and renovascular disease, 37-44.
Pooresmaeil, M., Iranpour, S., & Aghamohammadi, M. (2023). Effects of a nurse-led structured home visiting program on quality of life and adherence to treatment in hemodialysis patients. Frontiers in public health, 11, 1013019.
Ren, Q., Lian, M., Liu, Y., Thomas‐Hawkins, C., Zhu, L., & Shen, Q. (2019). Effects of a transtheoretical model‐based WeChat health education programme on self‐management among haemodialysis patients: A longitudinal experimental intervention study. Journal of advanced nursing, 75(12), 3554-3565.
Sulymbona, D. R., Setyawati, R., & Khasanah, F. (2020). Hubungan Antara Dukungan Keluarga Dan Motivasi Dengan Kualitas Hidup Pada Pasien Yang Menjalani Terapi Hemodialisa di RSI Sultan Agung Semarang. Puinovakesmas, 1(1), 43-51.
Safi, F., Areshtanab, H. N., Ghafourifard, M., & Ebrahimi, H. (2024). The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study. BMC nephrology, 25(1), 207.
Saguban, R., Shanmugam, S. R., Rondilla, E., Buta, J., Alatawi, N. A. H., Maestrado, R., & Alreshidi, M. S. (2025, February). Self-efficacy, social support, and depression: mediators of medication adherence in dialysis patients. In Healthcare (Vol. 13, No. 4, p. 425). MDPI.
Song, Y. Y., Chen, L., Wang, W. X., Yang, D. J., & Jiang, X. L. (2022). Social support, sense of coherence, and self-management among hemodialysis patients. Western journal of nursing research, 44(4), 367-374.
Sotoudeh, R., & Alavi, M. (2023). The effect of educational intervention on the quality of life of family caregivers of hemodialysis patients: A randomized controlled trial. Journal of education and health promotion, 12(1), 62.
Tao, Y., Liu, T., Zhuang, K., Fan, L., Hua, Y., & Ni, C. (2023). Perceived stress, social support, and insomnia in hemodialysis patients and their family caregivers: an actor-partner interdependence mediation model analysis. Frontiers in Psychology, 14, 1172350.
Taylor, K. S., Umeukeje, E. M., Santos, S. R., McNabb, K. C., Crews, D. C., & Hladek, M. D. (2023). Context matters: a qualitative synthesis of adherence literature for people on hemodialysis. Kidney360, 4(1), 41-53.
Valsaraj, B. P., Bhat, S. M., Prabhu, R., & Kamath, A. (2021). Follow-up study on the effect of cognitive behaviour therapy on haemodialysis adherence: a randomised controlled trial. Sultan Qaboos University Medical Journal, 21(1), e58.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Yunancik Zaenal Siswanto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
