Long-term nurse-patient interactions: factors in patient compliance or noncompliance to the dietary regimen

Noncompliance to treatment regimens is a widespread, costly problem. The present study examines nurse-patient interactions as factors in compliance/noncompliance to the hemodialysis dietary regimen. Several research studies have evidenced these interactions to be central to patient compliance. However, no research has been reported that has controlled for the nature of the treatment regimen; rather, practitioners' interactions with patients who are being treated for a variety of disorders have been examined. An interaction-process-analysis technique was used to code the verbal behaviors that occur during treatment between 38 hemodialysis outpatients with chronic renal disease and the nurses who provide their treatment. These verbal interactions were analyzed in relation to levels of dietary compliance/noncompliance of patients and length of nursing tenure. It was found that emotionally positive and negative responses by nurses were both positively associated with noncompliance to the dietary regimen; however, treatment-related responses by nurses were not associated with compliance/noncompliance level. With regard to length of nursing tenure, it was found that emotionally positive and negative responses by patients were positively associated with nursing tenure and that treatment-related questions by nurses were negatively associated with nursing tenure.