CYNICAL HOSTILITY, POWERFUL OTHERS CONTROL EXPECTANCIES, AND PATIENT ADHERENCE IN HEMODIALYSIS

Objective: The present study examined the joint role of cynical hostil ity and powerful others health locus of control expectancies in predic ting regimen adherence in a sample of center hemodialysis patients. Me thod: Forty-eight hemodialysis patients completed the Cook-Medley Host ility (He) Scale and the Powerful Others Health Locus of Control (PHLC ) scale. Adherence to the fluid-restriction and phosphorus reduction c omponents of the treatment regimen was assessed by examining patients' interdialysis session weight gains and serum phosphorus (P) levels. R esults: In a hierarchical regression analysis, higher hostility was as sociated with significantly higher serum P levels indicating poorer di etary and medication adherence. The main effect for hostility was qual ified by the interaction of hostility and PHLC. This pattern indicated that the deleterious effect of hostility on adherence was most pronou nced among patients possessing the expectancy that positive health out comes are not strongly contingent on the actions or advice of powerful others (eg; health care providers). Similar analyses failed to show s ignificant effects for hostility or PHLC in the prediction of interdia lytic weight gain. Conclusions: The present findings suggest that join tly assessing hostility and health-related expectancies may be useful in identifying chronically ill patients who are potentially at risk fo r difficulties in performing a prescribed regimen.