The association between attitudes toward aging and treatment adherence in rural elderly hemodialysis patients in Chengdu, China: a cross-sectional study

This study examined the relationship between attitudes toward aging and treatment adherence in rural elderly patients undergoing maintenance hemodialysis (MHD). A total of 213 patients aged ≥60 years and on dialysis for ≥3 months were recruited from five tertiary hospitals in Chengdu, Sichuan Province, China, between February and June 2022. Sociodemographic data were collected using a general information questionnaire, attitudes toward aging were assessed with the Attitudes Toward Aging Scale, and treatment adherence-including diet, fluid, medication, and dialysis-was measured with the Treatment Adherence Scale. Pearson correlation, binary logistic regression, and stratified regression analyses were performed. Of the participants, 38% had a positive attitude toward aging and 62% had a negative attitude. Attitudes toward aging were positively correlated with treatment adherence (r = 0.41, P < 0.001). Logistic regression identified male gender (OR = 0.16, 95% CI: 0.07-0.38), taking 1-2 medications (OR = 0.02, 95% CI: 0.002-0.04), social activity participation (OR = 0.44, 95% CI: 0.19-0.99), fluid adherence (OR = 0.77, 95% CI: 0.65-0.91), and medication adherence (OR = 0.70, 95% CI: 0.54-0.91) as protective factors for positive attitudes toward aging. Stratified regression revealed that family visit frequency, medical insurance, satisfaction with healthcare, and attitudes toward aging significantly influenced treatment adherence (△R² = 0.28, P < 0.05). Findings suggest a bidirectional relationship between attitudes toward aging and treatment adherence, highlighting the need to foster positive aging perceptions, enhance health education, and strengthen social support to improve well-being in elderly MHD patients.