ArticlePloS one2024
Structural equation modelling of the role of cognition in functional interference and treatment nonadherence among haemodialysis patients.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Factors Contributing to Non-Adherence to Treatment Among Adult Patients with Long-Term Haemodialysis: An Integrative Review.Nursing reports (Pavia, Italy) · 2025Review
- Patient and Health Care Provider Perspectives of Cognitive Difficulties in Dialysis.Kidney international reports · 2025Article
- Article
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11 authors.
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Abstract
BACKGROUND AND
objectivesCognitive impairment is common in haemodialysis patients and associated with adverse health outcomes. This may be due to cognitive impairments interfering with daily functioning and self-care, but evidence is limited. This cross-sectional study aims to explore the interrelationships between cognition and functional outcomes in haemodialysis patients.
methodsHaemodialysis patients completed measures of objective cognitive function (Montreal Cognitive Assessment), everyday problem-solving skills (scenario-based task), and subjective cognitive complaints (self-report). Participants also self-reported sociodemographic information, functional interference, treatment nonadherence, and mood and fatigue symptoms. Patients' clinical data including comorbidities and lab results were extracted from medical record. Structural equation modelling was performed.
resultsA total of 268 haemodialysis patients (mean age = 59.87 years; 42.5% female) participated. The final model showed satisfactory fit: CFI = 0.916, TLI = 0.905, RMSEA = 0.033 (90% confidence interval 0.024 to 0.041), SRMR = 0.066, χ2(493) = 618.573 (p < .001). There was a negative association between objective cognitive function and subjective cognitive complaints. Cognitive complaints were positively associated with both functional interference and treatment nonadherence, whereas objective performance was not. Everyday problem-solving skills emerged as a distinct aspect of cognition not associated with objective performance or subjective complaints, but had additive utility in predicting functional interference.
conclusionsSubjective cognitive complaints and everyday problem-solving skills appear to be stronger predictors of functional variables compared to objective performance based on traditional tests. Routine screening of everyday cognitive difficulties may allow for early identification of dialysis patients at risk of cognitive impairment, functional interference, treatment nonadherence, and poor clinical outcomes.
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