Abstract
BACKGROUND: End-stage renal disease (ESRD) accompanied by depression is a rapidly increasing global healthcare burden, and the use of tele-based continuous care to improve depression and treatment compliance in dialysis patients has become a common medical practice. This article examines how tele-based continuous care affects treatment compliance in ESRD patients with and without depression. METHODS: Participants satisfying the inclusion and exclusion criteria were recruited from the nephrology departments and dialysis units of 15 tertiary, A-grade hospitals in Anhui Province, China, from October to December 2023. A final total of 549 patients completed a valid follow-up survey. Covariance-based structural equation modeling (CB-SEM) was used for path analysis between variables, testing the mediating effects of the nurse-patient relationship and health belief. Additionally, a multi-group comparison was used to analyze the difference between the groups with and without depression. RESULTS: Path analyses suggest a significant positive association between tele-based continuous care and treatment compliance in dialysis patients (β = 0.147; p < 0.001). The effect of the nurse-patient relationship on the treatment compliance of dialysis patients proved to be insignificant (β = 0.059; p = 0.498). The effect of tele-based continuous care on compliance in the depression group occurs only through health belief (β = 0.220; p = 0.006). While the effect of tele-based continuous care on compliance in the non-depression group all exist except through nurse-patient relationship (β = 0.006; p = 0.879). CONCLUSIONS: This study validated the effect of tele-based continuous care on treatment compliance in dialysis patients and examined compliance outcomes in dialysis patients with and without depression. The results of this study can support the improvement of the tele-based continuous care system and the improvement of treatment compliance with depressed dialysis patients.