Patients who said that their ill health had interfered with social activities, isolated them, or created a burden to family, and who lacked family support, were more likely to die during the study period. These patients were also less likely to follow their doctors' orders (such as controlling weight), maintain dialysis, or possess physical quality of life. Surprisingly, staff encouragement and support did not help patients follow medical orders. The investigators also noted some country-to-country differences; for example, Japanese patients had a particularly high risk of dying during the study if they felt dissatisfied with family support.

"The presence of supportive people who can participate in care is an important source of strength for patients faced with hemodialysis," said Dr. Combe. "These study results raise the possibility that social-support interventions may improve patient care. Such interventions could strengthen other psychosocial factors, improve survival and enhance quality of life."

SOURCE American Society of Nephrology