Skip to main content

Advertisement

SpringerLink
Log in

Effects of perceived autonomy support and basic need satisfaction on quality of life in hemodialysis patients

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients’ perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients’ basic needs and in turn influences their HRQOL.

Methods

A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction.

Results

The empirical results of SEM indicated that the HD patients’ perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores.

Conclusion

Autonomy support from physicians and nurses contributes to improving HD patients’ HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Thomas, B., Wulf, S., Bikbov, B., Perico, N., Cortinovis, M., de Vaccaro, K. C., … Mehrotra, R. (2015). Maintenance dialysis throughout the world in years 1990 and 2010. Journal of the American Society of Nephrology, 26(11), 2621–2633.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jofre, R., López-Gómez, J. M., & Valderrábano, F. (2000). Quality of life for patient groups. Kidney International, 57, S121-S130.

    Article  Google Scholar 

  3. Christensen, A. J., & Ehlers, S. L. (2002). Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research. Journal of Consulting and Clinical Psychology, 70(3), 712.

    Article  PubMed  Google Scholar 

  4. Griffin, K. W., Wadhwa, N. K., Friend, R., Suh, H., Howell, N., Cabralda, T., … Eitel, P. E. (1994). Comparison of quality of life in hemodialysis and peritoneal dialysis patients. In R. Khanna (Ed.), Advances in peritoneal dialysis. Conference on peritoneal dialysis (Vol. 10, pp. 104–108). Toronto: Peritoneal Dialysis Publications.

  5. Ware, J. E. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.

    Article  PubMed  Google Scholar 

  6. Finkelstein, F. O., Wuerth, D., & Finkelstein, S. H. (2009). Health related quality of life and the CKD patient: Challenges for the nephrology community. Kidney International, 76(9), 946–952.

    Article  PubMed  Google Scholar 

  7. Kalantar-Zadeh, K., Kopple, J. D., Block, G., & Humphreys, M. H. (2001). Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. Journal of the American Society of Nephrology, 12(12), 2797–2806.

    CAS  PubMed  Google Scholar 

  8. Kimmel, P. L., & Patel, S. S. (2006). Quality of life in patients with chronic kidney disease: Focus on end-stage renal disease treated with hemodialysis. Seminars in Nephrology, 26, 68–79.

    Article  PubMed  Google Scholar 

  9. Mapes, D. L., Lopes, A. A., Satayathum, S., Mccullough, K. P., Goodkin, D. A., Locatelli, F., … Bommer, J. (2003). Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney International, 64(1), 339–349.

    Article  PubMed  Google Scholar 

  10. Mujais, S. K., Story, K., Brouillette, J., Takano, T., Soroka, S., Franek, C., … Finkelstein, F. O. (2009). Health-related quality of life in CKD patients: Correlates and evolution over time. Clinical Journal of the American Society of Nephrology, 4(8), 1293–1301.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Østhus, T. B. H., Preljevic, V. T., Sandvik, L., Leivestad, T., Nordhus, I. H., Dammen, T., & Os, I. (2012). Mortality and health-related quality of life in prevalent dialysis patients: Comparison between 12-items and 36-items short-form health survey. Health and Quality of Life Outcomes, 10(1), 1.

    Article  Google Scholar 

  12. Revuelta, K. L., López, F. J. G., de Alvaro Moreno, F., & Alonso, J. & CALVIDIA Group. (2004). Perceived mental health at the start of dialysis as a predictor of morbidity and mortality in patients with end-stage renal disease (CALVIDIA Study). Nephrology Dialysis Transplantation, 19(9), 2347–2353.

    Article  Google Scholar 

  13. Turkmen, K., Yazici, R., Solak, Y., Guney, I., Altintepe, L., Yeksan, M., & Tonbul, H. Z. (2012). Health-related quality of life, sleep quality, and depression in peritoneal dialysis and hemodialysis patients. Hemodialysis International, 16(2), 198–206.

    Article  PubMed  Google Scholar 

  14. Wan, E. Y., Chen, J. Y., Choi, E. P., Wong, C. K., Chan, A. K., Chan, K. H., & Lam, C. L. (2015). Patterns of health-related quality of life and associated factors in Chinese patients undergoing hemodialysis. Health and Quality of Life Outcomes, 13(1), 1.

    Article  Google Scholar 

  15. Peng, Y. S., Chiang, C. K., Hung, K. Y., Chang, C. H., Lin, C. Y., Yang, C. S., … & Chang, C. F. (2011). Comparison of self-reported health-related quality of life between Taiwan hemodialysis and peritoneal dialysis patients: A multi-center collaborative study. Quality of Life Research, 20(3), 399–405.

    Article  PubMed  Google Scholar 

  16. Birmelé, B., Le Gall, A., Sautenet, B., Aguerre, C., & Camus, V. (2012). Clinical, sociodemographic, and psychological correlates of health-related quality of life in chronic hemodialysis patients. Psychosomatics, 53(1), 30–37.

    Article  PubMed  Google Scholar 

  17. Ramirez, S. P., Macêdo, D. S., Sales, P. M. G., Figueiredo, S. M., Daher, E. F., Araújo, S. M., … Carvalho, A. F. (2012). The relationship between religious coping, psychological distress and quality of life in hemodialysis patients. Journal of Psychosomatic Research, 72(2), 129–135.

    Article  PubMed  Google Scholar 

  18. Mollaoğlu, M. (2013). Quality of life in patients undergoing hemodialysis. Rijeka: INTECH Open Access Publisher.

    Google Scholar 

  19. Simmons, R. G., & Abress, L. (1990). Quality-of-life issues for end-stage renal disease patients. American Journal of Kidney Diseases, 15(3), 201–208.

    Article  CAS  PubMed  Google Scholar 

  20. Mollaoglu, M. (2004). Depression and health-related quality of life in hemodialysis patients. Dialysis & Transplantation, 33(9), 544–555.

    Google Scholar 

  21. Braga, S. F. M., Peixoto, S. V., Gomes, I. C., Acúrcio, F. D. A., Andrade, E. I. G., & Cherchiglia, M. L. (2011). Factors associated with health-related quality of life in elderly patients on hemodialysis. Revista de Saude Publica, 45(6), 1127–1136.

    Article  PubMed  Google Scholar 

  22. Vasilieva, I. A. (2006). Quality of life in chronic hemodialysis patients in Russia. Hemodialysis International, 10(3), 274–278.

    Article  PubMed  Google Scholar 

  23. Bayoumi, M., & Alwakeel, J. (2012). Hemodialysis patients needs priorities according to Maslow’s Hierarchy and quality of life. Palliative Care & Medicine, 2(2), 1–5.

    Google Scholar 

  24. Bayoumi, M. (2012). Identification of the needs of haemodialysis patients using the concept of Maslow’s hierarchy of needs. Journal of Renal Care, 38(1), 43–49.

    Article  PubMed  Google Scholar 

  25. Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2008). Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. European Health Psychologist, 10(1), 2–5.

    Google Scholar 

  26. Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268.

    Article  Google Scholar 

  27. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.

    Article  CAS  PubMed  Google Scholar 

  28. De Charms, R. (1968). Personal causation. New York: Academic Press.

    Google Scholar 

  29. Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.

    Book  Google Scholar 

  30. Harter, S. (1978). Effectance motivation reconsidered. Toward a developmental model. Human Development, 21(1), 34–64.

    Article  Google Scholar 

  31. Ryan, R. M., & Deci, E. L. (2002). Overview of self-determination theory: An organismic dialectical perspective. In E. L. Deci & R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3–33). Rochester, NY: University of Rochester Press.

    Google Scholar 

  32. White, R. W. (1959). Motivation reconsidered: The concept of competence. Psychological Review, 66(5), 297–333.

    Article  CAS  PubMed  Google Scholar 

  33. Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497–529.

    Article  CAS  PubMed  Google Scholar 

  34. Williams, G. C., Deci, E. L., & Ryan, R. M. (1998). Building health-care partnerships by supporting autonomy: Promoting maintained behavior change and positive health outcomes. In P. Hinton, A. L. Suchman, & R. Botelho (Eds.), Partnerships in healthcare: Transforming relational process (pp. 67–87). Rochester, NY: University of Rochester Press.

    Google Scholar 

  35. Baard, P. P., Deci, E. L., & Ryan, R. M. (2004). Intrinsic need satisfaction: A motivational basis of performance and weil-being in two work settings1. Journal of Applied Social Psychology, 34(10), 2045–2068.

    Article  Google Scholar 

  36. Deci, E. L., La Guardia, J. G., Moller, A. C., Scheiner, M. J., & Ryan, R. M. (2006). On the benefits of giving as well as receiving autonomy support: Mutuality in close friendships. Personality and Social Psychology Bulletin, 32(3), 313–327.

    Article  PubMed  Google Scholar 

  37. deCharms, R. (1968). Personal causation. New York: Plenum.

    Google Scholar 

  38. Kasser, V. M., & Ryan, R. M. (1999). The relation of psychological needs for autonomy and relatedness to health, vitality, well-being and mortality in a nursing home. Journal of Applied Social Psychology, 29, 935–954.

    Article  Google Scholar 

  39. Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998). Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychology, 17(3), 269.

    Article  CAS  PubMed  Google Scholar 

  40. Williams, G. C., Lynch, M. F., McGregor, H. A., Ryan, R. M., Sharp, D., & Deci, E. L. (2006). Validation of the” important other” climate questionnaire: Assessing autonomy support for health-related change. Families, Systems, & Health, 24(2), 179.

    Article  Google Scholar 

  41. Deci, E. L., & Ryan, R. M. (1985). The general causality orientations scale: Self-determination in personality. Journal of Research in Personality, 19(2), 109–134.

    Article  Google Scholar 

  42. Kasser, T., & Ryan, R. M. (1996). Further examining the American dream: Differential correlates of intrinsic and extrinsic goals. Personality and Social Psychology Bulletin, 22, 280–287.

    Article  Google Scholar 

  43. Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics. Oxford: Oxford University Press.

    Google Scholar 

  44. Williams, G. C., McGregor, H. A., King, D., Nelson, C. C., & Glasgow, R. E. (2005). Variation in perceived competence, glycemic control, and patient satisfaction: Relationship to autonomy support from physicians. Patient Education and Counseling, 57(1), 39–45.

    Article  PubMed  Google Scholar 

  45. Arora, N. K., Weaver, K. E., Clayman, M. L., Oakley-Girvan, I., & Potosky, A. L. (2009). Physicians’ decision-making style and psychosocial outcomes among cancer survivors. Patient Education and Counseling, 77(3), 404–412.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Chiu, Y. W., Teitelbaum, I., Misra, M., de Leon, E. M., Adzize, T., & Mehrotra, R. (2009). Pill burden, adherence, hyperphosphatemia, and quality of life in maintenance dialysis patients. Clinical Journal of the American Society of Nephrology, 4(6), 1089–1096.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kring, D. L., & Crane, P. B. (2009). Factors affecting quality of life in persons on hemodialysis. Nephrology Nursing Journal, 36(1), 15.

    PubMed  Google Scholar 

  48. Liem, Y. S., Bosch, J. L., & Myriam Hunink, M. G. (2008). Preference-based quality of life of patients on renal replacement therapy: A systematic review and meta-analysis. Value in Health, 11(4), 733–741.

    Article  PubMed  Google Scholar 

  49. Tamura, M. K. (2009). Incidence, management, and outcomes of end-stage renal disease in the elderly. Current Opinion in Nephrology and Hypertension, 18(3), 252.

    Article  PubMed Central  Google Scholar 

  50. Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., & Deci, E. L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23(1), 58–66.

    Article  PubMed  Google Scholar 

  51. Johnston, M. M., & Finney, S. J. (2010). Measuring basic needs satisfaction: Evaluating previous research and conducting new psychometric evaluations of the basic needs satisfaction in General Scale. Contemporary Educational Psychology, 35(4), 280–296.

    Article  Google Scholar 

  52. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(3), 297–334.

    Article  Google Scholar 

  53. Nunnally, J. C. (1978). Psychometric theory (2nd edn.). New York: McGraw-Hill.

    Google Scholar 

  54. Anderson, J. C., & Gerbing, D. W. (1988). An updated paradigm for scale development incorporating unidimensionality and its assessment. Journal of Marketing Research, 25, 186–192.

    Article  Google Scholar 

  55. Hair, J. F. Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th edn.). New Jersey: Prentice-Hall.

    Google Scholar 

  56. Marcoulides, G. A., & Schumacker, R. E. (1996). Advanced structural equation modeling. Mahwah, NJ: Erlbaum.

    Google Scholar 

  57. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.

    Article  Google Scholar 

  58. Ng, J. Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7(4), 325–340.

    Article  PubMed  Google Scholar 

  59. Ryan, R. M., & Deci, E. L. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. NewYork: Guilford Publications.

    Google Scholar 

Download references

Acknowledgements

This work was partly supported by a grant from the Ministry of Science and Technology of Taiwan (MOST-105-2410-H-002-194-SSS). The views are solely those of the authors and do not represent the views of any agency.

Author information

Authors and Affiliations

  1. Department of Business Management, College of Management, Tatung University, Taipei City, Taiwan, Republic of China

    Mei-Fang Chen

  2. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei City, Taiwan, Republic of China

    Mei-Fang Chen, Ray-E Chang & Hung-Bin Tsai

  3. Division of Hospital Medicine, Department of Traumatology, National Taiwan University Hospital, Taipei City, Taiwan, Republic of China

    Hung-Bin Tsai

  4. Department of Health Industry Management, School of Healthcare Management, Kainan University, Taoyuan City, Taiwan, Republic of China

    Ying-Hui Hou

Authors
  1. Mei-Fang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ray-E Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hung-Bin Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ying-Hui Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ray-E Chang.

Ethics declarations

Conflict of interest

Ray-E Chang has received research Grant from the Ministry of Science and Technology of Taiwan and he declares that he has no conflict of interest. Mei-Fang Chen, Hung-Bin Tsai, and Ying-Hui Hou declare that they have no conflict of interest.

Ethical approval

Collection and analysis of the data in this study were approved by the Research Ethics Committee A of the National Taiwan University Hospital (NTUH-REC No. 201309090RINA).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, MF., Chang, RE., Tsai, HB. et al. Effects of perceived autonomy support and basic need satisfaction on quality of life in hemodialysis patients. Qual Life Res 27, 765–773 (2018). https://doi.org/10.1007/s11136-017-1714-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-017-1714-2

Keywords

Search

Navigation