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Abstract：
Background The management of end-stage renal disease (ESRD) demands meticulous adherence to treatment regimens, encompassing hemodialysis (HD) sessions, medication protocols, dietary guidelines, and fluid restrictions. The intricate interplay of factors impacting treatment adherence warrants comprehensive exploration, particularly within Pakistan. Objective To assess knowledge, adherence, and perception regarding the treatment regimens and their determinants among ESRD patients. Methodology Employing a nonprobability, consecutive sampling method, this prospective, cross-sectional study was conducted in July and August 2023 at Lahore General Hospital, Lahore, Pakistan. It exclusively enrolled adult patients with a minimum three-month history of hemodialysis. Thorough demographic data were collected, followed by the meticulous administration of a translated version of the End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ) through face-to-face interviews in the native language. IBM SPSS Statistics for Windows, Version 26 (released 2019; IBM Corp., Armonk, New York, United States) was used to acquire descriptive statistics, as well as Pearson\'s and Spearman\'s correlations and univariate and multivariate regression analysis. Results The study encompassed 119 patients, with a mean age of 43.13 ± 14.99 years. Adherence scores revealed means of 921.83 ± 28.37 for males and 865.18 ± 28.81 for females, out of 1200. Notably, only 10.1% demonstrated good adherence, 31.9% displayed moderate adherence, and 58% exhibited poor adherence. A statistically significant association emerged between better adherence and access to personal transportation (β=-0.225; 95% CI -178.24 to -20.77, p=0.014), with no other demographic factors predicting adherence. Conclusion The study underscores the sobering reality of minimal optimal adherence. Chief impediments include anxiety, alongside challenges such as fistula complications, financial constraints, transportation barriers, and inadequate counseling and motivation. Evidently, robust patient education, sustained motivation, and unwavering support from healthcare providers and institutional entities are imperative to surmount the multifaceted barriers that compromise treatment adherence.
摘要：
背景：终末期肾病（ESRD）的治疗需要一丝不苟地坚持治疗方案，包括血液透析（HD）会议，药物方案,饮食指南，和流体限制。影响治疗依从性的因素的复杂相互作用值得全面探索，尤其是在巴基斯坦。目的评估知识，坚持,以及对ESRD患者治疗方案及其决定因素的看法。采用非概率的方法论，连续抽样方法，这个前景，横断面研究于2023年7月和8月在拉合尔总医院进行，拉合尔,巴基斯坦。它专门招募了至少有三个月血液透析史的成年患者。收集了彻底的人口统计数据，随后通过母语面对面访谈，精心管理终末期肾病坚持问卷（ESRD-AQ）的翻译版本。IBMSPSSStatisticsforWindows,版本26（2019年发布；IBMCorp.,Armonk,纽约,美国)被用来获取描述性统计数据，以及Pearson和Spearman的相关性以及单因素和多元回归分析。结果本研究共纳入119例患者,平均年龄43.13±14.99岁。坚持得分显示男性为921.83±28.37，女性为865.18±28.81，1200值得注意的是,只有10.1%的人表现出良好的依从性，31.9%表现出中等依从性，58%的人表现出较差的依从性。在更好的依从性和获得个人交通工具之间出现了统计学上的显着关联（β=-0.225;95％CI-178.24至-20.77，p=0.014），没有其他人口统计学因素预测依从性。结论该研究强调了最小最佳依从性的清醒现实。主要障碍包括焦虑，除了瘘管并发症等挑战，财政限制，交通障碍,咨询和动力不足。显然,强大的患者教育，持续的动机，医疗保健提供者和机构实体的坚定支持对于克服影响治疗依从性的多方面障碍至关重要。
