فهرست مطالب a. akbarzadeh pasha

The level of patient adherence to treatment and medication orders is one of the important factors influencing the effectiveness of medical treatments. The aim of this study is to investigate the relationship between doctor-patient communication skills and the level of adherence to medication orders after discharge from the hospital.

This cross-sectional study was conducted on 284 patients admitted to the surgery and urology departments of Shahid Beheshti Hospital in Babol, where at least 48 hours had passed since their admission. Patients completed two questionnaires of doctor-patient communication skills (range 21-70) and Burton communication skills (range 18-90) in the hospital. Then, two weeks after discharge, the patients answered the two questionnaires of general adherence and the Morisky Medication Adherence Scale online or by telephone contact, and the results were analyzed.

The mean age of the participating patients was 50.65±18.20 years and the score of general adherence to treatment orders was 24.26±5.77 (range 7-30) and medication adherence was 8.54±2.91 (range 1-11). 222 patients (78.2%) had high adherence to treatment orders. Stepwise regression analysis showed that doctors’ communication skills were a positive factor in medication adherence (p<0.001, ß=0.336) and adherence to treatment orders (p<0.001, ß=0.331). Moreover, patients’ communication skills had a positive effect on medication adherence (p=0.01, ß=0.137) and general adherence to treatment orders (p<0.001, ß=0.205).

The results of the study showed that the communication skills of doctors and patients is a positive predictor of adherence to treatment and medication orders after discharge from the hospital.

Chronic kidney disease is one of the major health problems in todaychr('39')s world that creates a threatening situation for the health and socioeconomic status of the affected person, his/her family and the whole society. Due to the fact that in chronic diseases, a spiritual crisis appears in the individual, this study was therefore conducted to investigate the effect of spiritual health on resilience in patients undergoing hemodialysis.

This cross-sectional study was performed on 130 patients undergoing hemodialysis in Shahid Beheshti Hospital in Babol in 2017-2018. Data were collected and analyzed using Spiritual Well Being Scale (SWBS) (Paloutzian & Ellison) with a score of 20-125 at three levels of low, medium and high, as well as Connor-Davidson Resilience scale (CD-RISC) with a score of 20-125 at three levels of low, medium and high.

In this study, 5 (3.8%) patients had low, 81 (62.3%) had medium and 44 (33.8%) had high spiritual health. The mean score of spiritual health was 87.80±21.12 and was at a medium level. Furthermore, 6 patients (4.6%) had low resilience, 95 patients (73.1%) had medium and 29 patients (22.3%) had high resilience. The mean total resilience score was 86.63±19.48 and was at a medium level. The relationship between spiritual health and resilience was direct and significant (p<0.001, r=0.62).

The present study showed that spiritual health has a significant and positive relationship with resilience of patients undergoing hemodialysis treatment.