Determinants of Fluid Restriction Adherence among Hemodialysis Patients: A Single-Center Cross-Sectional Study

Yeni  Yulianti; Teten  Tresnawan

doi:10.56303/jhnresearch.v4i3.498

Authors

Yeni Yulianti Sekolah Tinggi Ilmu Kesehatan Sukabumi
Teten Tresnawan Sekolah Tinggi Ilmu Kesehatan Sukabumi

Keywords:

Age, Family Support, Educational Level, Fluid restriction compliance, knowledge

Abstract

Fluid restriction compliance refers to a patient's adherence to the prescribed limit of fluid intake to maintain optimal health. This compliance is influenced by factors such as age, education level, family support, and knowledge. The purpose of this study was to explore how these factors impact fluid restriction adherence among hemodialysis patients. This correlational research used a cross-sectional design with a sample of 155 hemodialysis patients from Jampangkulon Regional Hospital, selected through proportional random sampling. Data were collected via a questionnaire and analyzed using chi-square and logistic regression. The study found that a majority of patients were compliant with fluid restrictions (71.0%), and most possessed good knowledge on the topic (80.6%). Bivariate analysis identified significant effects of age (p=0.030), education (p=0.041), family support (p=0.015), and knowledge (p=0.001) on compliance. After controlling for all factors in a logistic regression model, knowledge emerged as the sole statistically significant predictor of compliance (p=0.028). In conclusion, while age, education, family support, and knowledge were all correlated with adherence, knowledge was the most significant factor in predicting compliance. It is recommended that Jampangkulon Regional Hospital enhance educational programs and involve families in patient care to improve compliance.

Downloads

Download data is not yet available.

References

Kim IS, Kim S, Yoo TH, Kim JK. Diagnosis and treatment of hypertension in dialysis patients: a systematic review. Clin Hypertens. 2023 Sep 1;29(1):24.

Wijayanti YT, Sasarari ZA, Sumiyati S, Prasetyowati P, Rusli R. Motivation Can Improve Medication Adherence in Hypertension Patients. Jurnal Edukasi Ilmiah Kesehatan. 2024;2(3):78–85.

Ismunandar I, Collein I, Khaira N. Overview of Nutritional Status of Patients with Chronic Kidney Disease Who Undergoing Hemodialisis. Poltekita: Jurnal Ilmu Kesehatan. 2024 Aug 31;18(2):172–7.

Tange Y, Takesawa S. Purification of central dialysis fluid delivery system for hemodialysis: practical training on the east kyushu medical valley project. Health Technol (Berl). 2024;14(4):765–71.

Almutary H, AlShammari N. Treatment of depression and poor quality of life through breathing training in hemodialysis patients. BMC Nephrol. 2025;26(1):16.

Özkan İ, Taylan S. Artículo Original Diet and fluid restriction experiences of patients on hemodialysis: a meta-synthesis study. Rev Nefrol Dial Traspl. 2022;42(1):22–40.

Mora-Bravo FG, Torres PTM, Campoverde NR, Carcelen GLB, Mancheno JCS, Tipanta ÁCS, et al. Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study. BMC Nephrol. 2025;26(1):30.

Sukartini T, Efendi F, Putri NS. A phenomenological study to explore patient experience of fluid and dietary restrictions imposed by hemodialysis. Journal of Vascular Nursing. 2022;40(2):105–11.

Torabikhah M, Farsi Z, Sajadi SA. Comparing the effects of mHealth app use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in hemodialysis patients: a randomized clinical trial. BMC Nephrol. 2023;24(1):194.

Song Y, Reifsnider E, Zhao S, Xie X, Chen H. A Randomized Controlled Trial of the Effects of a Telehealth Educational Intervention on Medication Adherence and Disease Activity in Rheumatoid Arthritis Patients. J Adv Nurs. 2020;76(5):1172–81.

Lee H, Cho M. Effects of Shared Decision-Making, Health Literacy, and Self-Care Knowledge on Self-Care Behavior Among Hemodialysis Patients in Korea: A Cross-Sectional Survey. Healthcare. 2025;13(2):175.

Langham RG, Kalantar‐Zadeh K, Bonner A, Balducci A, Hsiao L, Kumaraswami L, et al. Kidney Health for All: Bridging the Gap in Kidney Health Education and Literacy. Brazilian Journal of Medical and Biological Research. 2022;55.

Billany RE, Thopte A, Adenwalla S, March DS, Burton JO, Graham‐Brown M. Associations of Health Literacy With Self-Management Behaviours and Health Outcomes in Chronic Kidney Disease: A Systematic Review. J Nephrol. 2023;36(5):1267–81.

Hsu S, Lin Y, Koo M, Creedy D, Tsao Y. Health‐literacy, Self‐efficacy and Health‐outcomes of Patients Undergoing Haemodialysis: Mediating Role of Self‐management. J Ren Care. 2024;50(4):342–52.

Marbun RM, Rabbani FD, Maya C, Karina SM. The Effect of Counseling With Dietary Journal on Knowledge, Attitude, and Compliance of Renal Failure Patients on Haemodialysis Therapy. Sanitas Jurnal Teknologi Dan Seni Kesehatan. 2023;14(1):42–52.

Fauzi A, Oktaviani Y. Effects of a Hemodialysis Diet Education Program on Hemodialysis Patients. Kne Life Sciences. 2022;

Mananawan SP, Rosa EM. Association Between Attitudes to Self Management on Adherence in Restriction Fluid and Dietary Among Patient Hemodialysis Related to Hypervolemia. Josing Journal of Nursing and Health. 2022;3(1):42–53.

Sari F, Raveinal R, Apriyanti E. The Characteristic Description of Compliance With Fluid Limitation, Interdyalitic Weight Gain (Idwg), and Quality of Life in Hemodialysis Patients in Palembang City. International Journal of Nursing and Midwifery Science (Ijnms). 2020;4(2):132–40.

Badariati B, Sino NA. Relationship between Knowledge and Attitude of Mothers on Prevention of Dengue Hemorrhagic Fever in Children in the Work Area of the Kawatuna Health Center. Journal of Health and Nutrition Research. 2022 May;1(1):29–33.

Tekin I, Büber İ. Empowering Self-Management: Exploring Self-Care Practices in Heart Failure Patients. Pamukkale Medical Journal. 2024;

Kolasa J, Lisiak M, Grabowski M, Jankowska EA, Lelonek M, Nessler J, et al. Factors Associated With Heart Failure Knowledge and Adherence to Self-Care Behaviors in Hospitalized Patients With Acute Decompensated Heart Failure Based on Data From “The Weak Heart” Educational Program. Patient Prefer Adherence. 2021;Volume 15:1289–300.

Chen H, Wang S, Wu SJ, Lee CS, Fetzer S, Tsai LM. Effects of Predischarge Patient Education Combined With Postdischarge Follow-Ups on Self-Care, Readmission, Sleep, and Depression in Patients With Heart Failure. Journal of Nursing Research. 2020;28(5):e112.

Liu L, Qian X, Chen Z, He T. Health Literacy and Its Effect on Chronic Disease Prevention: Evidences From China’s Data. 2020;

Davison N, Stanzel K, Hammarberg K. The Impact of Social Determinants of Health on Australian Women’s Capacity to Access and Understand Health Information: A Secondary Analysis of the 2022 National Women’s Health Survey. Healthcare. 2024;12(2):207.

Degan TJ, Kelly PJ, Robinson L, Deane FP, Smith AM. Health Literacy of People Living With Mental Illness or Substance Use Disorders: A Systematic Review. Early Interv Psychiatry. 2020;15(6):1454–69.

Dehghani A. Health Literacy in Multiple Sclerosis Patients: A Concept Analysis Using the Evolutionary Method. J Caring Sci. 2021;10(1):49–56.

Šulinskaitė K, Zagurskienė D, Blaževičienė A. Patients’ Health Literacy and Health Behaviour Assessment in Primary Health Care: Evidence From a Cross-Sectional Survey. BMC Primary Care. 2022;23(1).

Aynaszyan S, Lonza GC, Sambare TD, Son SJ, Alvarez I, Tomasek G, et al. Limited Health Literacy Among Patients With Orthopedic Injuries: A Cross-Sectional Survey of Patients Who Underwent Orthopedic Trauma Surgery in a County Hospital Setting. Orthopedics. 2024;47(4):249–55.

Chen M, Kim HK. Cancer Fatalism in the Information Age: A Meta-Analysis of Communicative and Behavioral Correlates. Communic Res. 2023;51(1):83–111.

Wayunah W. Self-Efficacy and Compliance Fluid Intake Restriction as a Determinant of the Interdialytic Weight Gain (IDWG) Level. Journal of Nursing Care. 2022;5(1).

Nugroho FA, Rahmawati DA, Rahmadhani HTY. Adherence to Fluid Restriction and Quality of Life in Patients With Chronic Kidney Failure. 2021;

Alazwari IAH, Alarsan S, Alkhateeb NA, Salameh E. Designing Effective Health Education Programs: A Review of Current Research and Best Practices. The New Armenian Medical Journal. 2023;(2, 17 (2023)):105–9.

Suryasa IW, Gámez MR, Herrera-Velázquez MR, Koldoris T. Health Education Programs and Their Importance for Disease Prevention and Health Promotion. Int J Health Sci (Qassim). 2022;6(3):xi–xv.

Alatawi AA, Alaamri M, Almutary H. Social Support and Adherence to Treatment Regimens Among Patients Undergoing Hemodialysis. Healthcare. 2024;12(19):1958.

Hasnidar, Aswadi MW, Putra WUCJ. Family Support and Quality of Life for Chronic Kidney Disease (CKD) Patients Hemodialysis Therapy at Undata Hospital. Journal of Health and Nutrition Research. 2022;1(1):6–10.

Saritessa N, Ibrahim K, Haroen H. Booklet-Based Education in Diabetes Mellitus Patients: A Scoping Review. Journal of Health and Nutrition Research. 2025 Apr 24;4(1 SE-Articles):172–85.

Zhang X, Li S, Qin J, Han X, Su X, Qin L, et al. Correlation Between Self-Management, Psychological Cognitive Impairment, and Quality of Life in Elderly Chronic Obstructive Pulmonary Disease Patients. World J Psychiatry. 2025;15(4).

Giorgi G, Lecca LI, Pérez J, Pignata S, Topa G, Mucci N. Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment—A Narrative Review. Biomed Res Int. 2020;2020(1).

Sandys V, Sexton DJ, O’Seaghdha CM. Artificial Intelligence and Digital Health for Volume Maintenance in Hemodialysis Patients. Hemodialysis International. 2022;26(4):480–95.

Yang LJ, Chao F, Kuo I, Niu S, Hung C, Chiu Y, et al. High Ultrafiltration Rate Is Associated With Increased All-Cause Mortality in Incident Hemodialysis Patients With a High Cardiothoracic Ratio. J Pers Med. 2022;12(12):2059.

Hidayati N, Rokhman A, Suratmi S, Ghozali MS, Muhtadi M. The Effect of Virtual Education to Improve Compliance of Hemodialisys Patients With Health Protocols During Pandemic. Nurse and Health Jurnal Keperawatan. 2021;10(2):175–83.

Setiyawati NsY, Hariyati RrTS, Pujasari H, Novieastari E, Anisah NsS. Nurse Educators’ Experiences of Providing Education to Patients and Families. Nurs Manage. 2023;54(5S):36–42.

Mansour M, Parizad N, Maslakpak MH. Does Family‐centred Education Improve Treatment Adherence, Glycosylated Haemoglobin and Blood Glucose Level in Patients With Type 1 Diabetes? A Randomized Clinical Trial. Nurs Open. 2022;10(4):2621–30.