Skip to main content
SpringerLink
Log in

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

  • Empirical Research
  • Published:
Annals of Behavioral Medicine

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. U. S. Renal Data System:USRDS 1993 Annual Data Report. Bethesda, MD: The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease, 1993.

    Google Scholar 

  2. Hodsman AB, Cordy PE, Fraher LJ: Parathyroid hormone, vitamin D, and metabolic bone disease in dialysis patients. In Nissenson AR, Fine RN, Gentile DE (eds),Clinical Dialysis. Norwalk, CT: Appleton & Lange, 1990, 494–534.

    Google Scholar 

  3. Newberry MA:Textbook of Hemodialysis for Patient Care Personnel. Springfield, IL: Charles C Thomas, 1989.

    Google Scholar 

  4. Wolcott DW, Maida CA, Diamond R, Nissenson AR: Treatment compliance in end-stage renal disease patients on dialysis.American Journal of Nephrology. 1986,6: 329–338.

    PubMed  CAS  Google Scholar 

  5. Manley M, Sweeney J: Assessment of compliance in hemodialysis adaptation.Journal of Psychosomatic Research. 1986,30: 153–161.

    Article  PubMed  CAS  Google Scholar 

  6. Rosenstock IM: Historical origins of the Health Belief Model.Health Education Monographs. 1974,2(4): 328–335.

    Google Scholar 

  7. Larson EB, Olsen E, Cole W: The relationship of health beliefs and a postcard reminder to influenza vaccination.Journal of Family Practice. 1979,8: 1207–1211.

    PubMed  CAS  Google Scholar 

  8. Cummings KM, Jette AM, Brock BM: Psychosocial determinants of immunization behavior in a swine influenza campaign.Medical Care. 1984,4: 639–649.

    Google Scholar 

  9. Brownlee-Duffeck M, Peterson L, Simonds JF, et al: The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus.Journal of Consulting and Clinical Psychology. 1987,55: 139–144.

    Article  PubMed  CAS  Google Scholar 

  10. Cerkoney KA, Hart LK: The relationship between the Health Belief Model and compliance of persons with diabetes mellitus.Diabetes Care. 1980,3: 594–598.

    Article  PubMed  CAS  Google Scholar 

  11. Kirscht JP, Rosenstick IM: Patient adherence to antihypertensive medical regimens.Journal of Community Health. 1977,3: 115–124.

    Article  PubMed  CAS  Google Scholar 

  12. Taylor DW: A test of the Health Belief Model in hypertension. In Haynes RB, Taylor DW, Sackett DL (eds).Compliance in Health Care. Baltimore, MD: John Hopkins University Press, 1979, 103–109.

    Google Scholar 

  13. Cummings KM, Becker MH, Kirscht JP, Levin NW: Psychosocial factors affecting adherence to medical regimens in a group of hemodialysis patients.Medical Care. 1982,6: 567–581.

    Article  Google Scholar 

  14. Christensen AJ, Benotsch EG, Smith TW: Determinants of regimen adherence in renal dialysis. In Gochman DS (ed),Handbook of Health Behavior Research (Vol. 2). New York: Plenum (in press, 1997).

    Google Scholar 

  15. Kaplan RM, Simon HJ: Compliance in medical care: Reconsideration of self-predictions.Annals of Behavioral Medicine. 1990,12: 66–71.

    Article  Google Scholar 

  16. Wiebe JS, Christensen AJ: Patient adherence to chronic medical regimens: Personality and coping in context.Journal of Personality. 1996,64: 815–835.

    Article  PubMed  CAS  Google Scholar 

  17. Goldberg LR: The structure of phenotypic personality traits.American Psychologist. 1993,48: 26–34.

    Article  PubMed  CAS  Google Scholar 

  18. Costa PT, McCrae RR:NEO PI-R Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc., 1992.

    Google Scholar 

  19. Goldberg LR. An alternative “description of personality”: The Big-Five factor structure.Journal of Personality and Social Psychology. 1990,59: 1216–1229.

    Article  PubMed  CAS  Google Scholar 

  20. McCrae RR, Costa PT: Validation of the Five-Factor Model of personality across instruments and observers.Journal of Personality and Social Psychology. 1987,52: 81–90.

    Article  PubMed  CAS  Google Scholar 

  21. Block J: A contrarian view of the five-factor approach to personality description.Psychological Bulletin. 1995,117: 187–215.

    Article  PubMed  CAS  Google Scholar 

  22. McAdams DP: The Five-Factor Model in personality: A critical appraisal.Journal of Personality. 1992,60: 330–361.

    Article  Google Scholar 

  23. Eysenck HJ: Four ways five factors are not basic.Personality and Individual Differences. 1992,13: 667–673.

    Article  Google Scholar 

  24. Watson D, Clark LA: Structures of personality and their relevance to psychopathology.Journal of Abnormal Psychology. 1994,103: 18–31.

    Article  PubMed  CAS  Google Scholar 

  25. Smith TW, Williams PG: Personality and health: Advantages and limitations of the Five-Factor Model.Journal of Personality. 1992,60: 335–423.

    Article  Google Scholar 

  26. Marshall GN, Wortman CB, Vickers RR, et al: The Five-Factor Model of personality as framework for personality-health research.Journal of Personality and Social Psychology. 1994,67: 278–286.

    Article  PubMed  CAS  Google Scholar 

  27. Booth-Kewley S, Vickers RR: Associations between major domains of personality and health behavior.Journal of Personality. 1994,62: 281–298.

    Article  PubMed  CAS  Google Scholar 

  28. Rosenbaum M, Ben-Ari Smira K: Cognitive and personality factors in the delay of gratification of hemodialysis patients.Journal of Personality and Social Psychology. 1986,2: 357–364.

    Article  Google Scholar 

  29. Kaplan De-Nour A, Czaczkes JW: Personality factors in chronic hemodialysis patients causing non-compliance with medical regimen.Psychosomatic Medicine. 1972,34: 333–344.

    Google Scholar 

  30. Poll IB, Kaplan De-Nour A: Locus of control and adjustment to chronic hemodialysis.Psychological Medicine. 1980,10: 153–157.

    Article  PubMed  CAS  Google Scholar 

  31. Brickman AL, Yount SE, Blaney NT, et al: Personality and long-term health: Neuroticism, conscientiousness, and renal deterioration in Type I diabetes.Psychosomatics (in press, 1997).

  32. Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.New England Journal of Medicine. 1993,329: 977–1036.

    Article  Google Scholar 

  33. Reichard P, Nilsson BY, Rosenqvist U: The effect of long-term intensified insulin treatment on the development of microvascular complication of diabetes mellitus.New England Journal of Medicine. 1993,329: 304–309.

    Article  PubMed  CAS  Google Scholar 

  34. Christensen AJ, Smith TW: Personality and patient adherence: Correlates of the Five-Factor Model in renal dialysis.Journal of Behavioral Medicine. 1995,18: 305–313.

    Article  PubMed  CAS  Google Scholar 

  35. Becker MH, Maiman LA: Sociobehavioral determinants of complicance with health and medical care recommendations.Medical Care. 1975,13: 10–24.

    Article  PubMed  CAS  Google Scholar 

  36. Pedhazur EJ:Multiple Regression in Behavioral Research. New York: CBS College Publishing, 1982.

    Google Scholar 

  37. Bond GG, Aiken LS, Somerville SC: The Health Belief Model and adolescents with insulin-dependent diabetes mellitus.Health Psychology. 1992,11: 190–198.

    Article  PubMed  CAS  Google Scholar 

  38. Janis IL: The patient as decision maker. In Gentry WD (ed),Handbook of Behavioral Medicine. New York: Guilford, 1984.

    Google Scholar 

  39. Kawash GF, Woolcott DM, Sabry JH: Personality correlates of selected elements of the Health Belief Model.Journal of Social Psychology. 1980,112: 219–227.

    PubMed  CAS  Google Scholar 

  40. Cattell RB, Eber HW, Tatsuoka MM:Handbook for the Sixteen Personality Factor Questionnaire (16 PF) (Vol. 2). New York: Academic Press, 1970.

    Google Scholar 

  41. Christensen AJ, Smith TW, Turner CW, Cundick KE: Patient adherence and adjustment in renal dialysis: A person×treatment interactive approach.Journal of Behavioral Medicine. 1994,17: 549–566.

    Article  PubMed  CAS  Google Scholar 

  42. Christensen AJ, Turner CW, Smith TW: Health locus of control and depression in end-stage renal disease.Journal of Consulting and Clinical Psychology. 1991,59: 419–424.

    Article  PubMed  CAS  Google Scholar 

  43. Helgeson VS: Moderators of the relation between perceived control and adjustment to chronic illness.Journal of Personality and Social Psychology. 1992,63: 656–666.

    Article  PubMed  CAS  Google Scholar 

  44. Andrykowski MA, Brady MJ: Health locus of control and psychological distress in cancer patients: Interactive effects of context.Journal of Behavioral Medicine. 1994,17: 439–456.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Iowa, E-11 Seashore Hall, 52242, Iowa City, IA

    John S. Wiebe & Alan J. Christensen

Authors
  1. John S. Wiebe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alan J. Christensen
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Preparation of this manuscript was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases grant DK49129-01 awarded to Alan Christensen.

We thank the physicians who facilitated this work by permitting access to patient samples: Thomas Bainbridge, William Lawton, and John Whalen. Also, we appreciate the help of the nursing staff at each center in coordinating data collection efforts: Kathy Bender, Diane Bolyn, Shelley Engman, Sheila Kiesey, Mary Lincoln, Judy Sanders, and Fran Shepherd. We are grateful to John Michels and Rebekah Madel for their help in data collection and entry. Finally, we thank Lee Anna Clark and Jerry Suls for their comments on early versions of the manuscript.

About this article

Cite this article

Wiebe, J.S., Christensen, A.J. Health beliefs, personality, and adherence in hemodialysis patients: An interactional perspective. ann. behav. med. 19, 30–35 (1997). https://doi.org/10.1007/BF02883424

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02883424

Keywords

Search

Navigation