The Relationship between Therapeutic Compliance and Emotional Variables in the Patients on Maintenance Hemodialysis / 신경정신의학

ABSTRACT

OBJECTIVES: The purposes of this study were to evaluate the relationship between therapeutic compliance and emotional variables in the patients on maintenance hemodialysis and to make a help in planning the treatment in order to promote the therapeutic outcomes. METHODS: Subjects consisted of 43 end-stage renal disease patients who had been treated with hemodialysis for more than one year. Hostility was measured with Cook-Medly Hostility Scale and depressive symptom, with beck Depression Inventory(BDI) and anxiety, with Self-rating Anxiety Scale of Zung(SAS). Serum potassium(K), and phosphorus(P) level, and interdialytic weight gain(IWG) were selected as compliance indices, for they were said to reflect the effect of diet, medication and salts restriction, respectively. RESULTS: (1) While the patients on hemodialysis got the scores within the normal range in their anxiety and hostility scale, they showed higher score of BDI than normal person, which was wtatistically significant. (2) Considering the relationship between therapeutic compliance and emotional variables, diet compliance was significantly associated with the emotional variables such as depression and anxiety. The relationship would be drawn with the equation listed below; Compliance Value=4.656 x (Depression) + 2.592 x (Anxiety)-0.13 x (Depression)x(Anxiety)-9.742 (3) When the patients were given a series of supportive psychotherapy for about 1 month, they showed the decrease in the scores of anxiety and depression scales, and the elevation in compliance value. However, there was no room for saving that the compliance ratio was improved, because of the limitation in the research methodology. CONCLUSION: Therapeutic compliance depended on between depression and anxiety among the emotional variables, the supportive psychotherapy was useful method to improved the therapeutic compliance.