Construction and validation of structural equation modeling of factors influencing treatment adherence in maintenance hemodialysis patients
Objective To construct the structural equation of the influencing factors of the treatment compliance of maintenance hemodialysis patients based on the information-motivation-behavioral skill model,verify its internal pathway,and provide scientific bases for the intervention study under the guidance of the optimized model.Methods From July to November 2022,283 patients with maintenance hemodialysis were selected by convenience sampling method from 2 tertiary A hospitals in Henan Province.The hemodialysis patients'knowledge level questionnaire,social support rating scale,chronic disease self-efficacy scale,maintenance hemodialysis patients'self-management scale,dialysis treatment compliance scale of end-stage renal disease patients were investigated.SPSS25.0 was used to statistically describe the scores of patients'treatment compliance;correlation analysis of each scale was carried out;structural equation model was established by AMOS 24.0 software.Results 267 valid questionnaires were collected,and the effective recovery rate was 94.3%.Structural equation model showed that disease knowledge had no effect on self-management and treatment compliance(P>0.05);self-efficacy had a positive effect on treatment compliance(total effect 0.382,direct effect 0.183,indirect effect 0.199,P<0.05);social support had a positive effect on treatment compliance(total effect 0.699,direct effect 0.300,indirect effect 0.399,P<0.05);self-management had a positive effect on treatment compliance(total effect 0.183,direct effect 0.183,P<0.05).Conclusion When developing intervention strategies under the guidance of information-motivation-behavioral skill model,the emphasis should be placed on the promoting effect of motivation and behavioral skill factors on treatment compliance,especially the important pathway role of social motivation in the model,so as to improve the overall level of treatment compliance and quality of life of patients.
Maintenance HemodialysisTreatment ComplianceInformation-Motivation-Behavioral ModelStructural Equation ModelNursing Care