title: Long-term knowledge retention following predialysis psychoeducational intervention.
abstract: OBJECTIVE
  Early identification and predialysis psychoeducation are gaining acceptance. Although research supports the immediate value of predialysis interventions, long-term benefits remain unknown. We examined long-term knowledge retention following a psychoeducational intervention.
  
  
  METHODS
  47 progressive renal failure patients completed the Kidney Disease Questionnaire at baseline and 18, 30, 42, and 54 months after initiating renal replacement therapy (RRT; the 'longitudinal' sample). A larger cohort provided data at one or more of these points (n = 132, 117, 101, and 70 at 18, 30, 42, and 54 months, respectively; the 'cross-sectional' sample).
  
  
  RESULTS
  Initial knowledge gains among psychoeducation recipients were followed by a significant knowledge advantage for three groups throughout follow-up. Patients who received predialysis psychoeducation either before or after starting dialysis demonstrated superior Kidney Disease Questionnaire scores as compared with those identified before the initiation of RRT who received the usual standard of practice. Patients identified after the initiation of RRT and who received standard education, however, demonstrated the same level of knowledge retention as produced by psychoeducation. The results were identical across the longitudinal and cross-sectional samples.
  
  
  CONCLUSIONS
  Patient education produces important benefits in end-stage renal disease, but the incremental value of early intervention remains to be demonstrated.
authors.affiliation: Culture, Community, and Health Studies, Centre for Addiction and Mental Health (Clarke Division), University of Toronto and University Health Network, Toronto, Ont., Canada.
authors.forename: G M
authors.initials: GM
authors.lastname: Devins
authors.forename: D J
authors.initials: DJ
authors.lastname: Hollomby
authors.forename: P E
authors.initials: PE
authors.lastname: Barré
authors.forename: H
authors.initials: H
authors.lastname: Mandin
authors.forename: K
authors.initials: K
authors.lastname: Taub
authors.forename: L C
authors.initials: LC
authors.lastname: Paul
authors.forename: R
authors.initials: R
authors.lastname: Guttmann
authors.forename: Y M
authors.initials: YM
authors.lastname: Binik
mesh_terms: D000328:Adult; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000534:rehabilitation* / Q000628:therapy; D008297:Male; D008568:Memory; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D017582:Renal Replacement Therapy / Q000523:psychology*; D012917:Social Adjustment; D011795:Surveys and Questionnaires