Predictors of Adherence to Treatment in Hemodialysis Patients: A Structural Equation Modeling.

Background: Non-compliance to the treatment is a major problem in hemodialysis patients. This study aimed to determine factors predicting adherence to treatment in hemodialysis patients in selected cities of Khuzestan province, Iran. Methods: This cross-sectional study was conducted on 500 patients undergoing hemodialysis in Ahvaz, Shush, Shushtar, and Dezful cities. The data collection tools were ESRD-AQ, perceived health, perceived social support, Beck Depression, self-efficacy, and demographic and clinical factors questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient. Structural equation modeling (SEM) was employed to analyze the relationship between various exogenous and endogenous or mediating variables. Results: The results showed that all predicting variables of perceived social support, depression, self-efficacy, and perceived health had been associated with the variable of adherence to treatment. Accordingly, there was a reverse correlation between social support and depression (p< 0.001, r= -0.94), as well as depression and self-efficacy (p< 0.001, r= -0.87). There was a direct correlation between self-efficacy and perceived health (p< 0.001, r= 0.79), perceived health and adherence to treatment (p< 0.001, r= 0.72). Fitness indices also indicate the adequacy of the proposed model (X2/df= 4.94, CD=0.937, SRMR=0.076, TLI= 0.870, CFI= 0.873, RMSEA= 0.071). Conclusion: The results showed that high social support, low level of depression, high perceived self-efficacy, and high perceived health predicted better compliance with the treatment in hemodialysis patients. The proposed model can be used as a framework to improve adherence to treatment regimens in hemodialysis patients.

The survey of nursing students' attitude towards virtual education and its relationship with their satisfaction during the Covid-19 epidemic: A cross-sectional study.

BACKGROUND: Coronavirus disease 2019 (Covid-19) pandemic has increased virtual education use. This study aimed to determine the attitude of nursing students of Ahvaz Jundishapur University of Medical Sciences towards virtual education and its relationship with their satisfaction during the Covid-19 pandemic. MATERIALS AND METHODS: This descriptive-analytical study was conducted during 2020-2021 with the participation of 229 nursing students (undergraduate, graduate, and doctoral) who had spent at least one semester virtually at Ahvaz Jundishapur University of Medical Sciences. The sampling method was convenience. The data collection tool was a questionnaire consisting of three parts. The first part included students' demographic information and the second and third parts included the standard questionnaire of individual development and educational assessment to determine students' attitudes toward virtual education and their satisfaction with this type of education. IBM SPSS statistics 22 software and descriptive and analytical statistical tests were used for data analysis. RESULTS: According to the study results, the mean score of students' attitudes toward virtual education was 35.1 ± 11.3 and the mean score of students' satisfaction with this educational method was 88.3 ± 30.6, both of which are at the desired level. Also, a direct relationship was found between students' attitudes and satisfaction scores (P < 0.001). CONCLUSION: In this study, the attitude of nursing students to virtual education and their satisfaction with this educational method had been at the desired level. Therefore, the relevant authorities should also consider the necessary planning in the field of using this educational method and improving students' attitudes towards it under normal conditions.