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Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial |
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| Authors: | Vari Wileman Joseph Chilcot Christopher J. Armitage Ken Farrington David M. Wellsted Sam Norton |
| Affiliation: | 1. School of Psychology, University of Hertfordshire, Hatfield, UK;2. Health Psychology Section, Department of Psychology, Institute of Psychiatry, King’s College London, London, UK;3. Health Psychology Section, Department of Psychology, Institute of Psychiatry, King’s College London, London, UK;4. Manchester Centre for Health Psychology, School of Psychological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK;5. East &6. North Herts NHS Trust, Renal Unit Lister Hospital, Stevenage, UK |
| 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, 91 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 haemodialysis, 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. |
| Keywords: | self-affirmation behaviour change dialysis adherence interdialytic weight gain fluid control |