Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory based intervention : a randomised controlled trial
Author
Wileman, Vari
Chilcot, Joseph
Armitage, Christopher J.
Farrington, Ken
Wellsted, D.
Norton, Sam
Davenport, Andrew
Franklin, Gail
Da Silva Gane, Maria
Horne, Robert
Almond, Mike
Attention
2299/16957
Abstract
Objective Haemodialysis patients are at risk of serious health complications, yet treatment non-adherence remains high. Warnings about health-risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence. Design In a cluster randomised controlled trial, ninety-one patients either self-affirmed or completed a matched-control task before reading about the health-risks associated with inadequate fluid control. Outcome measures Patients' perceptions of the health-risk information, intention and self-efficacy to control fluid, were assessed immediately after presentation of health-risk information. Interdialytic-weight-gain (IDWG), excess fluid removed during hemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post intervention. Results Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy. Conclusion A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects.