Path Analysis on Factors Affecting the Use of Hemodialysis in Patients Chronic Renal Disease at Dr. Soehadi Prijonegoro Hospital Sragen, Central Java

Anisa Andriani, Didik Gunawan Tamtomo, Bhisma Murti


Background: Patient adherence can be influ­enced by several factors that can affect com­pli­ance with hemodialysis treatment. Adherence is highly treated while undergoing hemodialysis in order to achieve success in hemodialysis (HD) treatment. Adherence is one of the beha­viors of a person in achieving successful HD treatment. The success of a treatment can be influenced by several fac­tors, one of which is the use of HD. This study aimed to determine the effect of compliance with hemodialysis.

Subjects and Method: The was an obser­vational analytic study with a cross-sectional design. The study was conducted in January 2020. The sample used was 120 chronic kid­ney failure patients undergoing hemodialysis at Dr. Soehadi Prijonegoro Sragen Hospital. The de­pendent variable was compliance with hemo­dialysis. The independent variables are: know­ledge, length of care, family income. Data were collected by means of a question­naire. Data analysis was performed using path analysis with Stata 13.

Results: The use of HD in patients with chro­nic renal failure had a positive associa­tion with high HD knowledge (b= 1.22; 95% CI= 2.21 to -3.98; p= 0.027), length of stay (b= 2.09; 95% CI= 4.29 to 3.05; p<0.001), and has no positive relationship with family income (b = 0.40; 95% CI = 0.80 to 1.41; p = 0.426). The use of HD in patients with chro­nic renal failure is influenced indirectly by family income and length of treatment.

Conclusion: The use of HD in chronic renal failure patients has a direct relationship with knowledge of HD and length of treatment, and has no direct relationship with family income. The use of HD in patients with chro­nic renal failure is influenced indirectly by family income and length of treatment.

Keywords: hemodialysis, chronic renal failure

Correspondence: Anisa Andriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java. Email: andrianianisa390@gmail,com. Mo­bile: +6282220826660.

Journal of Health Policy and Management (2021), 06(01): 13-20


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Alikari V, Tsironi M, Matziou V, Tzavella F, Stathoulis J, Babatsikou F, Fradelos E, Zyga S (2018). The impact of education on knowledge, adherence and quality of life among patients on haemodialysis. Qual Life Res. 28(1):73-83.

Badan Penyelenggara Jaminan Sosial Kesehatan (2020). BPJS kesehatan kembangkan sistem penyederhanaan prosedur hemodialisa (BPJS Kesehatan Develops a Simplified Hemodialysis Procedure System).

Barzegar H, Jafari H, Charati JZ, Esmaeili R (2017). Relationship between duration of dialysis and quality of life in hemodialysis patients. Iran J Psychiatry Behav Sci. 11(4): e6409. https://-doi: 10.5812/ijpbs.6409.

Elata ABA, Elgazzar SE (2015). Relationship between hemodialysis patients' knowledge, psychological stress and social support with their quality of life. J Multidiscip Res. 01(33).

Ersan S, Liv F, Tanrisev M, Colak H, Yilmaz B, Alp A (2017). Hemodialysis patients’ knowledge and awareness about dietary sodium: There is still need for awareness raising interventions. Acta Medica Mediterranea. 33: 217. doi: 10.19193/0393-6384_2017_2_032.

Fadlalmola HA, Elkareem EMA (2020). Impact of an educational program on knowledge and quality of life among hemodialysis patients in Khartoum state. Int J Africa Nursing Sci. 12: 100205.

Indrarini A, Zahra AN, Yona S (2019). The relationship between anemia, depression, duration of hemodialysis, and quality of sleep among end-stage renal disease patients. Enferm Clin. 29(2): 24-29.

Lemos CF, Rodrigues MP, Veiga JRP (2015). Family Income is associated with quality of life in patients with chronic kidney disease in the pre-dialysis phase: A cross sectional study. Health Qual. Life Outcomes. 13: 202. https://doi 10.1186/s12955-015-0390-6.

Mailani F, Bakri SO (2019). The duration of hemodialysis treatment and the adherence of chronic kidney disease patients in fluid intake limitation: A Relationship. Indones J Nurs Sci. 1(1): 43 – 48.

Menteri Kesehatan Republik Indoneisa (2014). Peraturan Menteri Kesehatan Republik Indonesia Nomor 28 tahun 2014 tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasio-nal (Regulation of the Minister of Health of the Republic of Indonesia Number

of 2014 concerning Guidelines for Implementing the National Health Insurance Program). Jakarta

Menteri Kesehatan Republik Indonesia (2017). Peraturan Menteri Kesehatan Republik Indonesia Nomor 72 Tahun 2017 tentang Sistem Kesehatan Nasional (SKN) (Regulation of the Minis-ter of Health of the Republic of Indonesia Number 72 of 2017 concerning the National Health System (SKN).). Jakarta.

Murti B (2018). Prinsip dan metode riset epidemiologi edisi ke empat (Principles and methods of epidemiological research, fourth edition). Surakarta: Prodi Ilmu Kesehatan Masyarakat, Program Pascasarjana UNS.

Murti B, Ayuningrum IY (2019). Aplikasi path analysis & structural equation model dengan stata (Application path analysis & structural equation model with stata). Surakarta: Prodi Ilmu Kesehatan Masyarakat, Program Pascasarjana UNS.

Pratiwi DT, Tamtomo DG, Suryono A (2017). Determinants of the quality of life for hemodialysis patients. Indones J Medicine. 4(2): 145-154.

Shafiee MA, Chamanian P, Shaker P, Shahi-deh Y, Broumand B (2017). The impact of hemodialysis frequency and duration on blood pressure management and quality of life in end-stage renal disease patients. Healthcare 5(52): 1-9. doi: 10.3390/healthcare-5030052.

Spies HC, Berg VLVD, Nel M (2020). Knowledge, attitude and practices of patients receiving maintenance haemodialysis in Bloemfontein, South Africa. South Afr J Clin Nutr. 1-7.


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