Relationships among exercise of self-care agency, health locus of control, and compliance of the hemodialysis patient

This research project was designed to identify relationships among exercise of self-care agency, health locus of control and compliance of the hemodialysis patient. Instruments which measure exercise of self-care agency and health locus of control were administered to hemodialysis patients undergoing dialysis treatments in three outpatient dialysis units. Compliance indicators which included serum potassium, serum phosphorus, serum blood urea nitrogen and weight gains between treatments were compiled from the patient's medical record for a period of six months. Compliance data was correlated to scores on the written instruments. Additional demographic data and patient knowledge of the prescribed dialysis regimen were obtained through patient completion of a demographic data and screening tool.

Analysis of the data indicates that no significant relationships exist between health locus of control, exercise of self-care agency and compliance of the hemodialysis patient. These findings were not congruent with the those suggested by the conceptual framework, which suggested that the compliant patient would have an internal health locus of control and high exercise of self-care agency. While the study did indicate a high exercise of self-care agency of compliant patients, the health locus of control of the compliant patient was found to be of external orientation. Other findings of the study suggested a lack of patient knowledge of prescribed medical regimen in all areas of compliance.

Recommendations for future nursing research include both larger and longitudinal studies on self-care, compliance, health locus of control, and educational endeavors in the patient on dialysis. The unique aspects of serious chronic illness should direct some reconsiderations of the concepts of multidimensional HLOC and self-care in the development and use of both new and revised measurement tools.