Behavioral modeling to guide adherence to fluid control in hemodialysis patients.

OBJECTIVE

This study used the health belief model (HBM) and the transtheoretical model (TTM) to assess hemodialysis (HD) patients' readiness to comply with recommended fluid intake as it relates to their perceptions of therapy and disease.

DESIGN

This was a multicenter, cross-sectional study.

SETTING

The setting involved 3 hospital-based HD centers in Lebanon.

PATIENTS

Patients included 172 consenting HD patients who had been on HD for at least 3 months and were mentally stable.

INTERVENTION

Placement of patients into TTM stages was based on their readiness to comply with recommended fluid intake, as confirmed by 4-week interdialytic weight-gain measures, and taking into account their perceptions toward therapy (using HBM constructs).

MAIN OUTCOME MEASURES

Mean scores of HBM constructs for each patient were placed in one of the TTM stages of readiness to change.

RESULTS

This study included 54.1% males, the average age was 57.8 +/- 14.0 (SD) years, and average number of years on dialysis was 4.6 +/- 4.9. Regarding stages, 18.5% of participants were placed in precontemplation, 40.0% in contemplation, 38.1% in preparation, and 3.4% were in the action/maintenance stages. The HBM constructs were significantly associated with TTM (P < .01). Perceptions of benefits (P = .04) and self-efficacy (P < .01) were significantly associated with TTM.

CONCLUSION

Compliance is a multifaceted topic, essential for the survival and quality of life of HD patients. A better understanding of patients' beliefs and level of self-efficacy is a fundamental key to enhancing patients' compliance to therapy and achieving the required behavioral modifications.