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- The relationship between fatigue, pruritus, and thirst distress with quality of life among patients receiving hemodialysis: a mediator model to test concept of treatment adherencePublication . Sharif-Nia, Hamid; Maroco, J. P.; Sivarajan Froelicher, Erika; Barzegari, Saeed; Sadeghi, Niloofar; Fatehi, RezaHemodialysis is a conservative treatment for end-stage renal disease. It has various complications which negatively afect quality of life (QOL). This study aimed to examine the relationship between fatigue, pruritus, and thirst distress (TD) with QOL of patients receiving hemodialysis, while also considering the mediating role of treatment adherence (TA). This cross-sectional study was carried out in 2023 on 411 patients receiving hemodialysis. Participants were consecutively recruited from several dialysis centers in Iran. Data were collected using a demographic information form, the Fatigue Assessment Scale, the Thirst Distress Scale, the Pruritus Severity Scale, the 12-Item Short Form Health Survey, and the modifed version of the Greek Simplifed Medication Adherence Questionnaire for Hemodialysis Patients. Covariance-based structural equation modeling was used for data analysis. The structural model and hypothesis testing results showed that all hypotheses were supported in this study. QOL had a signifcant inverse association with fatigue, pruritus, and TD and a signifcant positive association with TA. TA partially mediated the association of QOL with fatigue, pruritus, and TD, denoting that it helped counteract the negative association of these complications on QOL. This model explained 68.5% of the total variance of QOL. Fatigue, pruritus, and TD have a negative association with QOL among patients receiving hemodialysis, while TA reduces these negative associations. Therefore, TA is greatly important to manage the associations of these complications and improve patient outcomes. Healthcare providers need to assign high priority to TA improvement among these patients to reduce their fatigue, pruritus, and TD and improve their QOL. Further studies are necessary to determine the most efective strategies for improving TA and reducing the burden of complications in this patient population.
- Psychometric properties of the Greek simplified medication adherence questionnaire among Iranian hemodialysis patientsPublication . Sharif-Nia, Hamid; Alikari, Victoria; Maroco, João; Fatehi, Reza; Hoseinzadeh, Esmaeil; Nowrozi, PooryaPatients suffering from chronic kidney failure ultimately need kidney replacement therapies, such as hemodialysis. Adherence to treatment in these patients can play a central role in improving health levels and feelings of well-being. The aim of this study was to determine the psychometric properties of the Persian version of the modified version of the Greek Simplified Medication Adherence Questionnaire in hemodialysis patients. In a methodological study carried out in 2024, a sample of 411 hemodialysis patients was selected using a convenience sampling method. The GR-SMAQ-HD utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory and confirmatory factor analysis, convergent validity, and divergent validity. Furthermore, the study examined the internal consistency of the scale to ensure its reliability. The mean age of the participants was 59.37 (SD = 12.99) years. The results of the tetrachoric correlation matrix with Varimax with Kaiser Normalization rotation using the first random dataset (n = 205) extracted three factors accounting for 74.4% of the variance comprising 8 items. The results of CFA showed that the data fit the model. As for construct reliability, Cronbach’s alpha, CR, AIC, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. In the overall population, the mean score for treatment Adherence was 5.61 (SD = 1.95, 95% CI 5.42, 5.80). Invariance analysis shows that the model has strong measurement invariance between sex ($ΔCFI= − 0.001, ΔRMSEA= − 0.004$). The findings affirm the appropriateness of employing the Persian iteration of the GR-SMAQ-HD as a dependable and valid instrument for assessing adherence to treatment in hemodialysis patients. GR-SMAQ-HD is crucial for ensuring that patients follow their prescribed treatment regimens effectively.