Patient Factors Associated with Adherence to Haemodialysis Therapy Among Patients with End-Stage Renal Disease at Renal Dialysis Centres in Gaborone, Botswana

Abstract

The study sought to determine the patient factors associated with adherence to haemodialysis therapy among patients with end-stage renal disease (ESRD) at renal dialysis centres in Gaborone, Botswana. The study used a descriptive analytical design. The study population comprised 191 patients with ESRD identified from patient registers, from whom a sample of 143 participants was determined using Yamane’s formula. The study collected data using a modified ESRD Adherence Questionnaire (ESRD-AQ). Descriptive statistics assessed adherence levels, while logistic regression identified patient factors associated with adherence. We assessed statistical significance at the 95% confidence level (p < 0.05). The findings showed high adherence to hemodialysis therapy, with 74.6% of participants demonstrating strong adherence. Adherence was significantly associated with age, gender, marital status, and educational attainment. Gender and educational level emerged as significant predictors of adherence. Female patients had significantly lower odds of adherence compared with male patients (OR = 0.32, 95% CI: 0.13–0.79, p = 0.013). Although age was not a statistically significant predictor, patients aged 45 years and above had nearly twice the odds of adherence compared with those younger than 45 years (OR = 1.95, 95% CI: 0.72–5.24, p = 0.187). The study concludes that patient-related characteristics, particularly gender and educational attainment, play an important role in adherence to haemodialysis therapy. Continuous health education and regular counselling are recommended to improve patients’ understanding of disease management and self-care practices. Dialysis units should also strengthen routine adherence monitoring by tracking attendance, shortened sessions, reasons for non-adherence, and incorporating adherence reports into monthly clinical reviews.