Effect of health contract intervention on renal dialysis patients in Korea

Abstract

This study is a randomized, controlled trial to examine the effect of the health contract intervention, based on the goal attainment theory, on the self-care behavior and physiological indices of renal dialysis patients in Korea. The experimental group (n = 21) underwent health contract intervention for 4 weeks, while the control group (n = 22) received routine care. The data were collected using questionnaires and measurement of physiological indices and analyzed using the SPSS WIN 12.0 program. A P value < 0.05 was considered statistically significant. Total score of self-care behavior (P = 0.011) and individual scores for behaviors, such as diet (P = 0.017), exercise and rest (P = 0.001), and blood pressure and body weight (P = 0.006) were higher in the experimental group. Serum potassium concentration and mean weight gain between dialysis sessions were significantly low in the experimental group (P = 0.002, P = 0.017). Therefore, the health contract intervention based on the goal attainment theory proved effective in improving self-care behavior and physiological indices (K, P, mean weight gain) in renal dialysis patients in Korea.

Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials

“…In fifteen studies (42%), theoretical models of behaviour relevant to treatment adherence formed the basis of the trialled intervention. The health belief model [27, 32, 41, 45] was the most commonly used, while self-efficacy theory [7, 45, 46], social cognitive theory [30, 47], self-affirmation theory [48, 49], trans-theoretical models (TTM) [35, 37], self-regulation theory [34], King’s theory of goal attainment [12] and the ABC (Antecedents, Behaviour, Consequences) model relevant to rational emotive therapy [33] were also invoked. Six out of seven studies, where the interventionist was a psychologist, had a theoretical behavioural underpinning.…”

“…The dominant category was assigned by consensus, with guidance when necessary from the senior psychologist among the authors. Eleven studies evaluated educational or cognitive interventions, four had behavioural or counselling interventions [6, 12, 27, 45], four had psychological or affective interventions [33, 39, 48, 49] and fourteen studies had elements of different categories in the trialled intervention (refer to Table 1).…”

“…The lack of standardized methods to measure adherence in these domains, contributes to the reported variations in the rate of non-adherence, and the difficulty of precisely estimating the effectiveness of interventions to improve adherence [3, 5]. Methods of measuring adherence vary across studies and include indirect measures, such as self-reported adherence [6, 7]; direct measures such as pill counts or electronic medication event monitoring system (MEMS) [8], and attendance in dialysis sessions [9]; as well as surrogate measures such as inter-dialytic weight gain [10, 11] or biochemical parameters, which include phosphate and potassium levels [12, 13].…”

Disentangling self-management goal setting and action planning: A scoping review

“…In the preparation phase, patients were often educated by means of written or visual materials (like workbooks, brochure, video’s or a website) (n = 13, 22%) [ 12 , 30 , 34 , 36 , 37 , 46 – 50 , 69 , 74 , 75 ] and/or in group meetings (n = 7, 12%) [ 42 , 46 , 47 , 51 – 53 , 74 ]. Patient reflection or self-assessment of their current status or behavior was usually done independently by the patients, without the help of a professional, by means of questionnaires (on paper or on a computer) (n = 5, 9%) [ 27 , 29 , 33 , 54 , 55 ] or self-care logs/diaries (n = 4, 7%) [ 28 , 30 , 37 , 42 ]. Bearon et al (2000) used ladder rating as a visual technique to reflect on the patient’s present status in acht self-selected functional areas (60).…”

“…Cho et al (2013) and Tomori et al (2012) used the method of contracting to document goals. Goals were written in the form of a contract, which was signed by both the professional and the patient [ 28 , 67 ]. Six articles (10%) used patient workbooks or manuals in which patients could write down their goals [ 12 , 13 , 53 , 69 , 74 , 80 ].…”