Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies.
BACKGROUND
We reviewed psycho-educational intervention studies that were designed to reduce interdialytic weight gain (IDWG) in adult hemodialysis patients. Our goals were to critique research methods, describe the effectiveness of tested interventions, and make recommendations for future research.


METHODS
Medline, PsychInfo, and the Cumulative Index to Nursing and Applied Health (CINAHL) databases were searched to identify empirical work. Each study was evaluated in terms of sample, design, theoretical framework, intervention delivery, and outcome.


RESULTS
Nine studies were reviewed. Self-monitoring appears to be a promising strategy to be considered to reduce IDWG. Theory was not usually used to guide interventions, designs generally had control groups, interventions were delivered individually, more than one intervention was delivered at a time, the duration of the intervention varied greatly, there was no long-term follow-up, IDWG was the only outcome, and IDWG was operationalized in different ways.


CONCLUSIONS
Theoretical models and methodological rigor are needed to guide future research. Specific recommendations on design, measurement, and conceptual issues are offered to enhance the effectiveness of future research.
Welch
Janet L
JL
Department of Adult Health, Indiana University School of Nursing, Indianapolis, 46202, USA. jwelch@iupui.edu
Thomas-Hawkins
Charlotte
C
D000328:Adult; D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000523:psychology*; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D016294:Models, Nursing; D008960:Models, Psychological; D015403:Nursing Evaluation Research / Q000592:standards; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D006435:Renal Dialysis / Q000009:adverse effects / Q000451:nursing / Q000523:psychology; D012107:Research Design / Q000592:standards; D012648:Self Care / Q000523:psychology; D016896:Treatment Outcome; D015430:Weight Gain