IMPROVING ADHERENCE TO FLUID RESTRICTIONS IN MALE HEMODIALYSIS-PATIENTS - A COMPARISON OF COGNITIVE AND BEHAVIORAL-APPROACHES

被引:22
作者
HEGEL, MT
AYLLON, T
THIEL, G
OULTON, B
机构
[1] DARTMOUTH COLL,HITCHCOCK MED CTR,DARTMOUTH MED SCH,HANOVER,NH 03756
[2] GEORGIA STATE UNIV,ATLANTA,GA 30303
[3] VET AFFAIRS MED CTR,DIALYSIS UNIT,W HAVEN,CT
关键词
HEMODIALYSIS; ADHERENCE; HEALTH BELIEFS; BEHAVIOR MODIFICATION;
D O I
10.1037/0278-6133.11.5.324
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
A cognitive intervention and a behavioral intervention were compared to determine their relative effectiveness in reducing interdialytic weight gain (IWG) among eight adult male hemodialysis patients. The behavioral model consisted of positive reinforcement, shaping, and self-monitoring. The cognitive model consisted of a counseling intervention designed to modify health beliefs. Three small-sample experimental studies showed that both interventions produced immediate reductions in IWG. However, the behavioral intervention was superior to the cognitive intervention in producing maintenance of reduced weight gain. Combining the interventions resulted in no improvement over the behavioral intervention alone. Continuation of self-monitoring procedures produced maintenance of improvements up to 2 months posttreatment Repeated-measures analysis of variance showed changes for only the "barriers" dimension of the health belief model (Hartman & Becker, 1978) (p<.001), and this occurred only following or concurrent with adherence behavior change. Suggestions for treatment and future research are offered.
引用
收藏
页码:324 / 330
页数:7
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