Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial. Issue 1 (2nd January 2016)

• Record Type: Journal Article
• Authors: Wileman, Vari; Chilcot, Joseph; Armitage, Christopher J.; Farrington, Ken; Wellsted, David M.; Norton, Sam; Davenport, Andrew; Franklin, Gail; Da Silva Gane, Maria; Horne, Robert; Almond, Mike
• Is Part Of: Psychology & health. Volume 31:Issue 1(2016)
• Page Start: 100
• Page End: 114
• Publication Date: 2016-01-02
• Subjects: self-affirmation -- behaviour change -- dialysis -- adherence -- interdialytic weight gain -- fluid control; Clinical health psychology -- Periodicals; Attitude to Health -- Periodicals; Public Opinion -- Periodicals; Psychology -- Periodicals; 150
• DOI: 10.1080/08870446.2015.1073729
• Languages: English
• ISSNs: 0887-0446

Abstract

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.