title: Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients.
abstract: Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.
authors.affiliation: Louisiana State University.
authors.forename: P J
authors.initials: PJ
authors.lastname: Brantley
authors.forename: T H
authors.initials: TH
authors.lastname: Mosley
authors.forename: B K
authors.initials: BK
authors.lastname: Bruce
authors.forename: G T
authors.initials: GT
authors.lastname: McKnight
authors.forename: G N
authors.initials: GN
authors.lastname: Jones
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D006435:Renal Dialysis / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D014040:Token Economy