Advertisement

Pediatric Nephrology

, Volume 20, Issue 12, pp 1823–1824 | Cite as

The impact of logistics and resilience on compliance

  • Jose GrünbergEmail author
Letter to the Editors

Sirs,

I have read with interest the article entitled “Why do they do that? The compliance conundrum” [1]. I would like to emphasize two points that I believe may complement Dr. Nevins’ editorial commentary: logistics and resilience as potential determinants of patient compliance. Noncompliance linked to logistics failures (NCLLF) is a major problem for poor people in developing countries. Public transportation is scarce, uncoordinated and, not exceptionally, chaotic. Thus, some patients who do wish to comply find insurmountable barriers in their way. Patients may face access barriers to medical appointments and medications for cost reasons. Even when those are free of charge, patients may face high costs because of the time and transportation costs involved and their inability to take time off from work. A survey was carried out in Uruguay to establish the patterns of travel to the hospital of 80 patients living more than 40 km away. The results illustrate these difficulties: 32 (40%)...

Keywords

Peritoneal Dialysis Pediatric Nephrologist Health Care Staff Electricity Cost Chronic Peritoneal Dialysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Nevins TE (2005) “Why they do that?” The compliance conundrum. Pediatr Nephrol DOI: 10 1007/s00467-005-1926-5Google Scholar
  2. 2.
    Grünberg J, Verocay MC, Rébori A, et al (2005) Twenty years pediatric chronic peritoneal dialysis in Uruguay: patient and technique survival. Pediatr Nephrol DOI: 10.1007/s00467-005-1939-0Google Scholar
  3. 3.
    Cyrulnik B (1999) Un mervellieux malheur. Odile Jacob, ParisGoogle Scholar
  4. 4.
    Charney DS (2004) Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry 161:195–216CrossRefPubMedGoogle Scholar
  5. 5.
    Grünberg J, Verocay C, Rébori A, Amaral C (2005) Centro de diálisis crónica pediátrica: ámbito y oportunidades de promoción de resiliencia. Arch Latinoam Nefrol Pediátr (in press)Google Scholar
  6. 6.
    White N, Bichter J, Koeckeritz J, Lee Ya, Munch KL (2002) A cross cultural comparison of family resiliency in hemodialysis patients. J Transcult Nurs 13:218–227CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2005

Authors and Affiliations

  1. 1.Servicio de Nefrología de Niños y Adolescentes (SENNIAD)Instituto de Medicina Altamente Especializada, Hospital EvangélicoMontevideoUruguay

Personalised recommendations