Factors Associated With Dietary Attitudes in Hemodialysis Patients: A Mixed-Methods Study

Area of Science:

• Nephrology
• Clinical Nutrition
• Psychosocial Health

Background:

• Dietary attitudes significantly impact self-management in hemodialysis patients.
• Clinical factors alone do not fully explain patient experiences with diet.

Purpose of the Study:

• To explore the associations between clinical and psychosocial factors and dietary attitudes in hemodialysis patients.
• To understand the lived experiences of patients with lower dietary attitude scores.

Main Methods:

• Explanatory sequential mixed-methods study involving 66 quantitative and 18 qualitative participants.
• Quantitative analysis included correlation and multivariable linear regression.
• Qualitative data were thematically analyzed and integrated with quantitative findings.

Main Results:

• The adjusted model explained 54.3% of the variance in dietary attitudes.
• Lower dietary attitudes correlated with longer hemodialysis duration, comorbidity, higher blood urea nitrogen, and triglyceride-to-HDL ratio.
• Higher ferritin levels were associated with higher dietary attitudes; qualitative themes revealed emotional, social, environmental, functional, and motivational barriers.

Conclusions:

• Dietary attitudes in hemodialysis are influenced by a combination of clinical and psychosocial factors.
• Qualitative findings highlight the complex experiences of patients with suboptimal dietary attitudes.
• Individualized, multidisciplinary support is recommended to overcome dietary self-management challenges.