The prediction of self-care behaviors in end-stage renal disease patients using Leventhal's Self-Regulatory Model.
OBJECTIVE
To assess the utility of Leventhal's Self-Regulatory Model (SRM) to predict self-care behavior with regard to dietary, medication, and fluid regimes in end-stage renal disease (ESRD) patients.


METHODS
In a prospective study, ESRD patients treated via hospital-based haemodialysis (N=73) were screened for cognitive deficits and completed questionnaires that enquired about illness perceptions, coping strategies, knowledge of kidney disease, and psychological distress at Time 1. Physiological proxy measures of self-care behaviors regarding diet (serum potassium levels), fluid intake (mean and standard deviation of interdialytic weight gain), and medication (serum phosphate levels) regimes were collected 3 weeks later at Time 2.


RESULTS
Illness representations (emotional and timeline perceptions) predicted self-care behaviors with regard to diet and medication. Emotion-focused coping strategies predicted higher levels of variation in adherence to fluid restrictions. Younger males were less likely to adhere to the fluid restrictions.


CONCLUSIONS
The SRM has predictive utility. Psychological interventions should focus on alleviating disease-specific distress and challenging erroneous timeline perceptions in order to increase adherence to dietary and medication regimes in ESRD patients. A more specific measure of coping for ESRD is required to clarify the role of coping strategies in this population. Younger, male patients should be targeted for extra support with fluid restrictions.
O'Connor
Susan M
SM
Section of Psychological Medicine, Medical Faculty, University of Glasgow, Glasgow, Scotland, UK. suzy.o'connor@aapct.scot.nhs.uk
Jardine
Alan G
AG
Millar
Keith
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004326:Drinking / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D055809:Illness Behavior; D007389:Internal-External Control; D007676:Kidney Failure, Chronic / Q000097:blood / Q000523:psychology* / Q000628:therapy; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D008960:Models, Psychological; D010349:Patient Compliance / Q000523:psychology; D010555:Personality Inventory; D010710:Phosphates / Q000097:blood; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000523:psychology; D012648:Self Care / Q000523:psychology*; D012803:Sick Role; D015430:Weight Gain / Q000502:physiology; D055815:Young Adult
D010710:Phosphates; D011188:Potassium