Behavioral intervention and adherence in hemodialysis

血液透析中的行为干预和依从性

• 批准号: 7142169
• 负责人: ALAN J CHRISTENSEN
• 金额: $ 20.19万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-15 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7142169
• 关键词: behavior therapy; behavioral /social science research tag; body fluid balance therapy; body water; chronic renal failure; clinical research; diet; health behavior; health services research tag; hemodialysis; human subject; human therapy evaluation; patient oriented research; therapy compliance; behavior therapy; behavioral /social science research tag; body fluid balance therapy; body water; chronic renal failure; clinical research; diet; health behavior; health services research tag; hemodialysis; human subject; human therapy evaluation; patient oriented research; therapy compliance

DESCRIPTION (provided by applicant): The aim of the proposed work is to conduct a randomized controlled trial (RCT) evaluation of a behavior change intervention designed to enhance fluid-intake adherence (compliance) among hemodialysis patients. Patient non-adherence (non-compliance) with fluid-intake restrictions is a highly pervasive problem in the hemodialysis population with substantial consequences in terms of increased patient morbidity and mortality. Given the prevalence and clinical importance of adherence among ESRD patients, the design and evaluation of interventions to improve patient adherence is critically important. Surprisingly, however, little such empirical work has been conducted in this area. The proposed RCT involves testing the efficacy of a behaviorally based, group-administered, "behavioral self regulation" intervention designed to increase adherence to fluid intake restrictions among hemodialysis patients. This structured intervention is designed to be delivered by healthcare providers in a clinical setting to groups of 4-10 patients over seven, one-hour weekly sessions. A randomized control group research design will be used in the proposed work to investigate the effect of the self-regulation intervention versus an attention placebo control on fluid-intake adherence in a sample of approximately 200 fluid non-adherent center hemodialysis patients over a 26-week follow-up period. Both clinical (interdialysis session weight gain) and self-report indices of fluid-intake adherence will be examined. We believe that the proposed research is of potentially very high impact given the high prevalence and clear clinical consequences of hemodialysis patient nonadherence and the potential for a relatively low-cost, structured intervention to significantly reduce this type of maladaptive patient behavior in the hemodialysis treatment context.

描述（由申请人提供）：拟议工作的目的是对旨在提高血液透析患者中​​流体依从性（合规性）的行为变化干预措施进行随机对照试验（RCT）评估。在血液透析人群中，患者不遵守（不合规）是一个高度普遍的问题，在患者的发病率和死亡率增加方面，其后果很大。鉴于ESRD患者依从性的普遍性和临床重要性，改善患者依从性的干预措施的设计和评估至关重要。令人惊讶的是，在这一领域几乎没有进行过这样的经验工作。拟议的RCT涉及测试以行为为基于行为的，群体管理的“行为自我调节”干预措施的疗效，旨在增加血液透析患者中​​液体摄入限制的依从性。这种结构化干预措施旨在由医疗保健提供者在临床环境中提供给七个每周一小时的4-10例患者的组。在拟议的工作中，将使用随机对照组的研究设计，以研究自我调节干预措施的影响与注意力安慰剂的控制对大约200次液体非疗养者中心血液透析患者的样本中的液体 - 能力依从性的影响。将检查临床（透析间的体重增加）和流体含量依从性的自我报告指数。我们认为，鉴于血液透析患者不依从性的高流行和明显的临床后果以及相对低成本，结构化的干预措施的潜力显着降低了血液透析治疗环境中这种疾病的患者行为，因此拟议的研究具有很大的影响。