Amin Sneha, Sangadi Irene, Allman-Farinelli Margaret, Boudville Neil, Haloob Imad, Harris David C H, Hawley Carmel M, Johnson David W, Lee Vincent W, Mai Jun, Rangan Anna, Roger Simon D, Sud Kamal, Vilayur Eswari, Rangan Gopala K
Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia.
Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia.
Kidney Int Rep. 2025 Apr 27;10(7):2265-2274. doi: 10.1016/j.ekir.2025.04.041. eCollection 2025 Jul.
Clinical practice guidelines suggest maintaining adequate hydration in people with autosomal dominant polycystic kidney disease (ADPKD). However, the long-term perceptions of increasing water intake and the role of self-efficacy tools are unknown.
Participants randomized to the increased water intake arm in a 3-year trial were purposively sampled and invited to semistructured interviews at the end of the study. In addition, all participants ( = 78) in the increased water intake arm were invited to complete a posttrial questionnaire.
Fifteen participants completed the interview and 48 (61.5%) completed the questionnaire. Participants were motivated to adhere to the increased water intake at the start of the trial, but it became more difficult over time. Approximately half of the participants found that it was "easy" to meet fluid intake goals without interfering with their lifestyle. The main barrier was "loss of control" particularly when implementing increased water intake at social events. Furthermore, participants' somatic and emotional state undermined motivation. Regarding self-efficacy tools, the act of carrying water bottles was considered most useful for monitoring intake; self-monitoring urine specific gravity provided positive reinforcement, and mobile phone text message reminders maintained engagement. At the end of the trial, most participants had established knowledge and habits required to increase water intake but the motivation to continue long-term was contingent on a medical benefit.
Habit formation to increase water intake was perceived as relatively uncomplicated by most participants. However, the gap between intention and behavior fluctuated because of intermittent social barriers and widened over time.
临床实践指南建议，常染色体显性多囊肾病（ADPKD）患者应保持充足的水分摄入。然而，人们对增加饮水量的长期认知以及自我效能工具的作用尚不清楚。
在一项为期3年的试验中，随机分配到增加饮水量组的参与者被有目的地抽样，并在研究结束时邀请他们参加半结构化访谈。此外，增加饮水量组的所有参与者（n = 78）被邀请完成一份试验后问卷。
15名参与者完成了访谈，48名（61.5%）完成了问卷。参与者在试验开始时积极遵守增加饮水量的要求，但随着时间的推移变得更加困难。大约一半的参与者发现，在不影响生活方式的情况下“轻松”达到液体摄入目标。主要障碍是“失去控制”，尤其是在社交活动中增加饮水量时。此外，参与者的身体和情绪状态削弱了积极性。关于自我效能工具，携带水瓶的行为被认为对监测摄入量最有用；自我监测尿比重提供了积极的强化作用，手机短信提醒保持了参与度。在试验结束时，大多数参与者已经掌握了增加饮水量所需的知识和习惯，但长期坚持的动力取决于医学益处。
大多数参与者认为增加饮水量的习惯养成相对简单。然而，由于间歇性的社会障碍，意图和行为之间的差距波动不定，并且随着时间的推移而扩大。
