Autonomy and adherence to individual with chronic renal disease

Abstract

The adherence of the sick individual is the main objective of this study, which was carried out through bibliographic review. Non adherence to therapeutical proposals is a frequent problem with medical, social and economic consequences for the involved sick individuals, services providers, and health system. It is possible to define and to quantify non adherence of individuals with chronic renal disease in regular hemodialysis programs evidenced in several indicators. The longer and more complex is the proposed treatment, the more frequent is nonadherence. Non-adherence increases mortality, morbidity, and costs of treatment. Causes for non-adherence are multi-factors, partially related to loss of control over personal life due to dependence. Individual’s rehabilitation requires possible recovery of independence, autonomy in order to change a receiver susceptible to an imposed treatment into an active partner of a therapeutic intervention. Proposed strategies involve negotiation with sick individual, a customized approach focused in the individual by using a biopsychosocial model.