Hegel M T, Ayllon T, Thiel G, Oulton B
Dartmouth Medical School, Lebanon, NH.
Health Psychol. 1992;11(5):324-30. doi: 10.1037//0278-6133.11.5.324.
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.
对一项认知干预和一项行为干预进行了比较，以确定它们在减少8名成年男性血液透析患者透析间期体重增加（IWG）方面的相对有效性。行为模型包括正强化、塑造和自我监测。认知模型包括旨在改变健康信念的咨询干预。三项小样本实验研究表明，两种干预都能使IWG立即降低。然而，在维持体重增加减少方面，行为干预优于认知干预。将两种干预结合起来并没有比单独的行为干预有更好的效果。自我监测程序的持续进行使治疗后长达2个月的改善得以维持。重复测量方差分析显示，仅健康信念模型（Hartman & Becker，1978）的“障碍”维度发生了变化（p < .001），且这种变化仅在依从行为改变之后或同时出现。文中还提供了治疗建议和未来研究方向。
