Associations between Health Literacy With Dialysis Adherence and Health Resource Utilization in Patients Receiving Maintenance Hemodialysis

Addressing the issue of health literacy in patients undergoing hemodialysis by following the treatment regimen and using health services can be an effective tool in improving the care services system to planners and health officials. Therefore, this study was conducted to determine the relationship between health literacy, adherence to treatment regimen and the use of health services utilization in hemodialysis patients referred to hemodialysis centers of Chaharmahal and Bakhtiari province, 2019.

This descriptive correlational study was conducted in 2019 on hemodialysis patients referred to hemodialysis centers in Chaharmahal and Bakhtiari province. A total of 162 patients undergoing hemodialysis were selected to take part in the study by convenience sampling method based on inclusion criteria. The data collection tools included demographic information questionnaire, Iranian urban population health literacy questionnaire (HELIA), treatment adherence questionnaire in hemodialysis patients (ESRD-AQ) and a researcher-made questionnaire on health services utilization. The validity and reliability of the questionnaires were reviewed and confirmed. Study data were analyzed by SPSS software version 23 using descriptive and inferential statistics.

According to the findings, the mean score of health literacy of the samples was 112.89 ± 26.04 and the majority of them (30.86%) were inadequately literate. In terms of adherence to the treatment regimen, the majority of samples (66.67%) adhered to the treatment moderately. Regarding the use of health services utilization during the past year, the majority of samples (68.52%) had not been going for emergency visits, and most of them (54.32%) had not been hospitalized. Among patients who needed to be hospitalized in the past year, the people who had been hospitalized once before were at majority (26.54%). Also, in terms of the number of days being in hospital, the majority of samples (70.99%) had been hospitalized for less than 5 days. Data analysis by Spearman correlation coefficient showed a significant relationship between health literacy and treatment adherence (P = 0.000). However, no significant relationship was found between health literacy and use of health services utilization and also between adherence to treatment and using health services utilization.

Nurses 'knowledge and awareness about patients' health literacy and its promotion can lead to more effective education in these patients and consequently the rate of following more treatment and using health services in these patients is reduced and the ground for Reduce treatment costs and hospitalization rates, which are largely the responsibility of the government.