Health Literacy and Attitudes to Holistic, Complementary, and Alternative Medicine in Peritoneal Dialysis Patients: A Descriptive Study

Published: 22 August 2022| Version 1 | DOI: 10.17632/6cjzffhhgk.1
nurcan uzdil,
Zuleyha Kılıç


Article information Article title Health Literacy and Attitudes to Holistic, Complementary and Alternative Medicine in Peritoneal Dialysis Patients- A Descriptive Study Authors Nurcan UZDİL* Züleyha KILIÇ Affiliations Nurcan Uzdil is Assistant Professor (RN, PhD), Faculty of Health Sciences, Department of Mental Health and Disease Nursing, Erciyes University, Kayseri, Turkey Züleyha Kılıç is Assistant Professor (RN, PhD), Department of Internal Diseases Nursing, Niğde Ömer Halisdemir University, Zübeyde Hanım School of Health, 51100, Niğde -Turkey. Corresponding author’s email address and Twitter handle Keywords Complementary and Alternative Medicine, Health Literacy, Holistic, Peritoneal Dialysis. Abstract İntroduction: Chronic renal failure (CRF) patients use many complementary and alternative medicine (CAM) practices to manage their symptoms. This research was conducted descriptively and relationally to determine the relationship between the attitudes of peritoneal dialysis patients toward holistic CAM and their health literacy (HL) levels. Methods: The study was conducted on 91 peritoneal dialysis patients who were treated in the adult peritoneal dialysis unit of a university, met the inclusion criteria, and agreed to participate in the study. Data were collected using the survey form Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) and Health Literacy Scale (HLS). Ethics committee approval, institutional permission, and informed consent of the patients included in the study were obtained. Results: It was observed that 72.5% of peritoneal dialysis patients use CAM, and the mean HCAMQ score was 24.03 ± 7.94. Moreover, 76.9% of the patients implementing CAM used herbal methods, and 92.3% preferred CAM to strengthen immunity. İn addition, 63.6% patients did not inform healthcare personnel about their CAM use. In the present study, the mean HLS score of peritoneal dialysis patients was 102.88 ± 21.06, and a statistically significant and negative correlation was observed between the mean HCAMQ and HLS scores (r=-0.240; p<0.05). Patients who reported their use of CAM to healthcare personnel had higher HLS scores than those who did not. A positive perception of health had a significant effect on both HCAMQ and HLS. Conclusion: The majority of peritoneal dialysis patients included in the study used CAM, and their attitudes toward CAM use were positive. Most of the patients did not report the use of CAM to healthcare personnel. The HL levels of the patients were high. Positive attitude toward HCAMQ increased as the HLS level increased.


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The data collection tools designed and verified by the researchers in the interview style were applied through the face-to-face interview technique. When the patients enrolled in the adult peritoneal dialysis unit came for their monthly controls, the researcher explained the purpose of the study to the patients who met the inclusion criteria. Questionnaires were asked by the researchers in a separate room in the unit to the patients who agreed to participate in the study, and it took approximately 15 min to fill out the forms for each patient. The data were evaluated in the IBM SPSS Statistics 21 statistical package program. Approval (2021/263) from the Erciyes University Clinical Research Ethics Committee and institutional permission from the Erciyes University Health Application and Research Center were obtained to conduct the study. The participants were informed that the collected personal data would not be shared with anyone, their identities would be kept confidential, and they could leave the study anytime. Before signing the consent form, patients who wanted to participate in the study were given a comprehensive explanation of the purpose and procedures of the study. Patients who volunteered to participate in the study were literate, were above 18 years of age, had peritoneal dialysis duration of 6 months or more, had cognitive competence to respond to survey questions, and were able to communicate verbally. The study data were collected through personal interview between May 10 – November 12, 2021. A total of 106 people were invited to the study. Among these individuals, 94 agreed to participate in the study. However, 3 people were excluded from the study because they gave incomplete answers to the questionnaire and scale questions. IBM SPSS Statistics 21 statistical package program was used for data analysis. Summary statistics of the variables are expressed as a number of units (n), percent (%), mean (x̄), median and standard deviation (SD). The Kolmogorov-Smirnov test was used to examine whether the variables met the normality assumption. According to the kurtosis (0.500) and skewness (0.253) coefficients of the variables and the coefficient of variation, the variables showed a normal distribution [24]. Hence, the independent-samples t-test was applied for binary variables and one-way analysis of variance (ANOVA) was used for three or more variables. Pearson’s rank correlation coefficient was used for correlation between variables. The relational status between the variables was tested with multivariate analysis, and p<0.05 was considered statistically significant in comparisons.


Erciyes Universitesi


Health, Patient, Peritoneal Dialysis, Complementary Medicine