Health beliefs, personality, and adherence in hemodialysis patients: an interactional perspective

Research examining the main effects of health beliefs and personality on medical regimen adherence has yielded inconsistent results. This study tested the hypothesis that health beliefs and personality predict adherence in an interactive manner. Components of the Health Beliefs Model, Conscientiousness (C) from the NEO-Five Factor Inventory, and regimen adherence were assessed in a sample of 70 in-center hemodialysis patients. In a hierarchical regression analysis, the interaction of health beliefs and C failed to explain a significant portion of the variance in interdialysis weight gain, a measure of adherence to fluid restrictions, after controlling for demographic characteristics. The interaction did significantly predict individual differences in serum phosphorus levels, a measure of diet and medication adherence. The effect was primarily attributable to the interaction of C and perceived severity. However, the combination of high C and high perceived severity was associated with poorer patient adherence. Such a pattern may be the result of defective coping patterns associated with high levels of anxious arousal and has implications for therapeutic interventions targeted at modifying health beliefs among chronically ill patients following prescribed medical regimens.