Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies

Welch, Janet L.; Thomas‐Hawkins, Charlotte

doi:10.1016/j.ijnurstu.2004.09.015

Cited by 45 publications

(38 citation statements)

References 36 publications

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“…Planning interventions to support patients with adherence to fluid/diet limitations is challenging, and a review of intervention studies (Welch and Thomas-Hawkins, 2005) found a small number of studies, frequent methodological issues and lack of a robust theoretical model to guide interventions. The recent study (Howren et al, 2016a) of fluid adherence suggests that those patients who believe health-related outcomes are a function of their own behaviors and that they have the opportunity to exert control could be most adherent to complex regimes.…”

Section: Discussionmentioning

confidence: 99%

Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients

et al. 2016

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Patients with chronic kidney disease (CKD) often require regular hemodialysis (HD) to prolong life. However, between HD sessions, patients have to restrict their diets carefully to avoid excess accumulation of potassium, phosphate, sodium, and fluid, which their diseased kidneys can no longer regulate. Failure to adhere to their renal dietary regimes can be fatal; nevertheless, non-adherence is common, and yet little is known about the psychological variables that might predict this dietary behavior. Thus, this study aimed to assess whether dietary adherence might be affected by a variety of psychological factors including stress, personality, and health locus of control, as well as dietary knowledge, in chronic HD patients. Fifty-one patients (30 men; age range 25–85) who had undergone HD for at least 3 months and had been asked to restrict at least one of potassium, phosphate or fluid, were recruited from a hospital renal unit. Measures of adherence to each of potassium, phosphate, and fluid were derived from standard criteria for these physiological indices in renal patients. Knowledge of food/drink sources of these dietary factors, and their medical implications in relation to HD and CKD were assessed by a bespoke questionnaire. Psychological factors including stress, personality and health locus of control beliefs were measured by standardized questionnaires. Having to restrict a particular nutrient was associated with better knowledge of both food sources and medical complications for that nutrient; however, greater dietary knowledge was not linked to adherence, and knowledge of medical complications tended to be associated with poorer adherence to potassium and phosphate levels. Adherence to these two nutrient requirements was also associated with lower reported stress in the past week. Adherence was associated with differences in locus of control: these differences varied across indices although there was a tendency to believe in external loci. For potassium, phosphate, and fluid restriction, adherers were less likely to be sensation seekers but did not differ from non-adherers on impulsivity, anxiety sensitivity, or hopelessness. In conclusion, the links between dietary adherence and stress, locus of control and personality suggests that screening for such psychological factors may assist in managing adherence in HD patients.

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Section: Discussionmentioning

confidence: 99%

Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients

et al. 2016

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“…Despite this, few studies examine educational interventions to improve fluid restriction adherence 7, 19. Even fewer studies assess patient fluid management knowledge, and often do not employ a validated instrument to measure this important factor 7, 20. Development of a validated assessment tool of patient knowledge of fluid management in dialysis is needed to identify gaps in patient knowledge, tailor individual educational interventions, and to evaluate the impact of these interventions.…”

Section: Discussionmentioning

confidence: 99%

Patient Perspectives on Fluid Management in Chronic Hemodialysis

Smith

Coston

Glock

et al. 2010

Journal of Renal Nutrition

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Objective-To describe the perspectives and experiences of chronic hemodialysis (CHD) patients regarding self-care and adherence to fluid restrictions.Design-Semi-structured focus groups. Setting-Two outpatient hemodialysis centers. Participants-19 patients on chronic hemodialysis.Intervention-Patients were asked a series of open-ended questions to encourage discussion about the management of fluid restriction within the broad categories of general knowledge, knowledge sources or barriers, beliefs and attitudes, self-efficacy, emotion, and self-care skills.Main outcome measure-We analyzed session transcripts using the theoretical framework of content analysis to identify themes generated by the patients.Results-Patients discussed both facilitators and barriers to fluid restriction which we categorized into 6 themes: knowledge, self-assessment, psychological factors, social, physical, and environmental. Psychological factors were the most common barriers to fluid restriction adherence, predominantly involving lack of motivation. Knowledge was the most discussed facilitator with accurate self-assessment, positive psychological factors, and supportive social contacts also playing a role. Dialysis providers were most commonly described as the source of dialysis information (54%), but learning through personal experience was also frequently noted (28%).Conclusion-Interventions to improve fluid restriction adherence of chronic hemodialysis patients should target motivational issues, assess and improve patient knowledge, augment social support, and facilitate accurate self-assessment of fluid status.

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“…HD'de en fazla stres yaratan ve tedaviye uyumda zorlanılan alan sıvı kısıtlamasıdır (4,19,21,22,23,24,25). Hastalık ilerledikçe HD hastaları idrar oluşturma yeteneklerini kaybeder.…”

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Hemodiyaliz Tedavisi Alan Bireylerin Sıvı Kısıtlamasına Uyum Düzeyleri

Karabulutlu¹,

Yilmaz²

2020

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ÖZETAmaç: Bu araştırma, hemodiyaliz tedavisi alan bireylerin sıvı kısıtlamasına uyum düzeylerini değerlendirmek ve sıvı kısıtlamasına uyumu etkileyen faktörleri belirlemek amacıyla yapılmıştır. Results: It was found that individuals receiving hemodialysis had a moderate level of concordance with fluid restriction (51.23±5.88); they had high levels of knowledge regarding fluid restriction (20.22±1.07); and they had a moderate level of concordance in terms of behavioral aspects (22.42±4.23), but low levels of concordance in terms of the attitudes aspect (8.59±2.61). Individuals' concordance with fluid restriction was found to be influenced by gender and marital status; knowledge level was found to be influenced by gender and treatment duration, and behavior was significantly influenced by gender. Women, in comparison to men, were found to have higher concordance levels in terms of knowledge, behavior and total fluid control aspects; single patients' level of concordance with total fluid control was higher compared to married patients, and the level of knowledge about fluid control was lower in patients who had had a treatment duration of 6 months to 2 years, in comparison with other groups. Interdialytic weight gain decreased with increasingly concordant attitudes and total scores for fluid control, and the amount of ultrafiltration needed decreased with the increase in behavior and total scores. Gereç ve Conclusion:It was found that individuals who received hemodialysis were not adequately concordant with fluid restriction. Individualized training and practice is required to increase concordance with fluid restriction.

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Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies

Cited by 45 publications

References 36 publications

Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients

Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients

Patient Perspectives on Fluid Management in Chronic Hemodialysis

Hemodiyaliz Tedavisi Alan Bireylerin Sıvı Kısıtlamasına Uyum Düzeyleri

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