An exploration of sociopsychological factors associated with suboptimal adherence to therapeutic regimens among patients on continuous ambulatory peritoneal dialysis

Peritonitis is a leading complication and has significant health and social consequences to end-stage kidney disease patients on continuous ambulatory peritoneal dialysis (CAPD). Prior research has shown that nonadherence to the therapeutic regimens is a risk factor of peritonitis. However, very few studies identified the factors associated with nonadherence. By applying the health belief modal, this study attempts to explore the risk perception of peritonitis and the sociopsychological factors that contribute to suboptimal adherence to the therapeutic regimens among patients on CAPD. Seven focus groups were conducted with CAPD patients (n = 34). The results indicated that the perception of susceptibility varied across patients’ past experience with peritonitis. Physical pain, prolonged hospitalization and technique failure, psychological distress, work and personal finance, and a burden to the family were identified as the health and social consequences of peritonitis. The patients perceived autonomy and independence and minimizing the sense of guilt as the benefits of adherence to therapeutic regimens. Perceived barriers to adherence included social activities and work, cost of treatment, fatigue, and environmental constraints. Patients considered adaptation to the CAPD treatment and a pessimistic attitude toward the kidney disease as sources of influence on their self-efficacy. Finally, patients mentioned the mutual support from other patients and the hotline provided by the renal center, at the public hospital, as effective cues to action. The discussion of findings emphasizes the design of health messages and intervention programs for health communicators and healthcare professionals.