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

Dietary attitudes are relevant to self-management in hemodialysis, but clinical associations alone cannot explain patients' experiences.

This explanatory sequential mixed-methods study included 66 patients quantitatively and 18 purposively selected patients with lower dietary attitude scores qualitatively. Correlations were evaluated with false discovery rate correction, followed by exploratory adjusted multivariable linear regression. Qualitative data were analyzed thematically and integrated through a joint display.

The exploratory adjusted model accounted for 54.3% of the variance. Longer hemodialysis duration, comorbidity, higher blood urea nitrogen, and a higher triglyceride-to-high-density lipoprotein ratio were associated with lower dietary attitude scores, whereas higher ferritin was associated with higher scores. Among participants with lower ASDTHP scores, themes involved emotional, social, environmental, functional, and motivational experiences.

Dietary attitudes were associated with clinical and psychosocial factors. The qualitative findings reflected participants with lower ASDTHP scores. Individualized multidisciplinary support may help address dietary self-management barriers.