Self-care Agency and Its Influential Factors in Hemodialysis Patients

Background & Aims: Chronic kidney disease is a destructive and irreversible process, which reduces glomerular filtration, decreases the ability of the kidneys to retain fluids and electrolytes, and disrupts water and urea balance, thereby leading to uremia.This disease is accompanied by constant hospitalization, reduced quality of life, high mortality, and extreme medical costs.End-stage kidney disease refers to the irreversible loss of the renal function, in which case the kidneys are unable to support the life of the patient, and kidney transplantation is considered to be the treatment of choice.Due to the unevenness of this process, the majority of the patients in the world must remain under hemodialysis treatment until the kidney transplant is performed.Today, hemodialysis is a common treatment for chronic kidney failure.The patients receiving hemodialysis experience limitations in their physical, mental, and social functioning and self-care activities in patients; this could play a key role in their adaptation to the disease process, improving the quality of life, and reducing the number of hospitalizations, length of hospital stay, treatment costs, and mortality.Given the importance of selfcare in hemodialysis patients and the need for care and treatment planning, the present study aimed to assess the ability of self-care and its influential factors in hemodialysis patients. Materials & Methods:This cross-sectional study was conducted with the permit of the Ethics Committee of Guilan University of Medical Sciences, Iran (IR.GUMS.REC.1395.310),starting in January 2016 until November 2017.The sample population included the patients referring to the hemodialysis ward of Razi Hospital in Rasht, who were selected via simple random sampling.Based on the Morgan table, the number of the sample was determined per 187 dialysis patients at this center to be 126.In order to compensate for the possible loss of the patients, 137 patients were enrolled in the study.During the study, four patients were excluded due to unwillingness to continue participation, and seven patients were excluded due to weakness and lethargy while completing the questionnaire; finally, 126 patients were evaluated.The inclusion criteria were the age of 18-75 years, ability in self-care, minimum dialysis history of three months, willingness to participate, and absence of physical and motor disabilities, mental retardation, and mental disorders.The exclusion criteria were weakness, lethargy, restlessness, and withdrawal from the study.Data were collected using a questionnaire consisting of two sections; the first section included individual-social data, and the second section was the modified form of the 28-item Chinese version of the self-care ability assessment, scored based on a five-point Likert scale (Not at All=1, Rarely=2, Usually=3, Often=4, Always=5).The final score was within the range of