Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations

Maya N. Clark-Cutaia, Mary Ann Sevick, Jennifer Thurheimer-Cacciotti, Leslie A. Hoffman, Linda Snetselaar, Lora E. Burke, Susan L. Zickmund

Research output: Contribution to journalArticlepeer-review


Barriers to following dietary recommendations have been described; however, they remain poorly understood. The purpose of this qualitative study was to explore perceived barriers to adherence to dietary recommendations in a diverse hemodialysis patient population. Participants were eligible to participate in a semi-structured qualitative telephone interview prior to randomization for an ongoing clinical trial to evaluate the efficacy of an intervention designed to reduce dietary sodium intake. Interviews were digitally recorded, transcribed verbatim and coded using an iterative qualitative process. In total, 30 (37% females, 53% Caucasians) participants, 63.2 ± 13.3 years, were interviewed. Time, convenience, and financial constraints hindered dietary adherence. Dietary counseling efforts were rated positively but require individualization. Ability to follow recommended guidelines was challenging. Suggestions for addressing barriers include technology-based interventions that allow patients to improve food choices and real-time decision-making, and permit tailoring to individual barriers and preferences.

Original languageEnglish (US)
Pages (from-to)1009-1029
Number of pages21
JournalClinical Nursing Research
Issue number8
StatePublished - Nov 1 2019


  • ESRD
  • dietary restrictions
  • health care disparities
  • patient adherence
  • vulnerable populations

ASJC Scopus subject areas

  • General Nursing


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