Impact of Nurses´ Solution-focused Communication on the Fluid Adherence of Adult Patients on Hemodialysis
Study Details
Study Description
Brief Summary
Aim: To test the hypothesis that fluid adherence in patients on hemodialysis can be improved through nurses´ solution-focused communication with patients on issues of adherence.
Design: Single-group quasi-experimental study. Method: A one-month baseline of inter-dialytic weight gain was taken for a group of 36 adult patients in a hospital hemodialysis unit. Then, the nurses of the unit received an 5-hour training in solution-focused communication on issues of fluid adherence and applied it with the patients of the sample. Inter-dialytic weight gains (IDWG) were measured during another month. Six months after the training, IDWG was again measured during one month.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Design A single-group quasi-experimental design was carried out. The IDWG was the dependent variable, expressed as the weight gain in kilograms between dialysis sessions. A base-line was established by taking IDWG data for one month; after the nurses training, IDWG data were taken for another month. Follow-up was carried out six months later.
Methods
Participants 36 patients of a hemodialysis unit in a public hospital were invited to participate in the study. All accepted and gave written informed consent. Nurses were two women (39 and 37 years old) and one man (30 years old).
The intervention Training. Two two-hour training modules were designed by two recognized solution-focused therapy experts. In each module, participants watched videos that illustrated solution-focused communication on fluid adherence, and practiced the skills in role-plays.
Solution-focused communication on IDWG. In the case of IDWG improvement, nurses were trained to congratulate the patient and then to explore in detail, from a stance of curiosity, how nurses had accomplished the weight reduction. Nurses were trained to invite patients to share specific behavioral details and also to describe their own behavior from the perspective of significant family members. Nurses were also taught to compliment patients on their accomplishments and to invite them to keep track of anything else they might find useful to control fluid intake over the next days.
In the case of IDWG worsening, nurses were encouraged to validate patients´ difficulties and empathize with their predicament.
A repeated measure analysis of variance (ANOVA) and Student's t were used to analyze the changes in patient's IDWG over time.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: nurses in the hemodialysis service Nursing Solution-Focused: Two two-hour training modules were designed by two recognized solution-focused therapy experts. In each module, participants watched videos that illustrated solution-focused communication on fluid adherence, and practiced the skills in role-plays. |
Behavioral: Nursing Solution-Focused
Two two-hour training modules were designed. In each module, participants watched videos that illustrated solution-focused communication on fluid adherence, and practiced the skills in role-plays. Solution-focused communication on IDWG. In the case of IDWG improvement, nurses were trained to congratulate the patient and then to explore in detail, from a stance of curiosity, how s/he had accomplished the weight reduction. Nurses were trained to invite patients to share specific behavioral details, to describe their own behavior from the perspective of significant family members and also to compliment patients on their accomplishments and to invite them to keep track of anything else they might find useful to control fluid intake over the next days.
|
Outcome Measures
Primary Outcome Measures
- ANOVA [Three months]
Analysis of Variance
Eligibility Criteria
Criteria
Inclusion Criteria:
- 0
Exclusion Criteria:
- 0
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | María del Carmen Neipp | Elche | Alicante | Spain | 03202 |
Sponsors and Collaborators
- Universidad Miguel Hernandez de Elche
Investigators
- Study Chair: Alberto Pastor, Universidad Miguel Hernández de Elche
Study Documents (Full-Text)
None provided.More Information
Publications
- Baines LS, Jindal RM. Non-compliance in patients receiving haemodialysis: an in-depth review. Nephron. 2000 May;85(1):1-7. Review.
- Bowles N, Mackintosh C, Torn A. Nurses' communication skills: an evaluation of the impact of solution-focused communication training. J Adv Nurs. 2001 Nov;36(3):347-54.
- Idier L, Untas A, Koleck M, Chauveau P, Rascle N. Assessment and effects of Therapeutic Patient Education for patients in hemodialysis: a systematic review. Int J Nurs Stud. 2011 Dec;48(12):1570-86. doi: 10.1016/j.ijnurstu.2011.08.006. Epub 2011 Sep 14. Review.
- Kugler C, Maeding I, Russell CL. Non-adherence in patients on chronic hemodialysis: an international comparison study. J Nephrol. 2011 May-Jun;24(3):366-75. doi: 10.5301/JN.2010.5823.
- Matteson ML, Russell C. Interventions to improve hemodialysis adherence: a systematic review of randomized-controlled trials. Hemodial Int. 2010 Oct;14(4):370-82. doi: 10.1111/j.1542-4758.2010.00462.x. Epub 2010 Aug 27. Review.
- McAllister M. Doing practice differently: solution-focused nursing. J Adv Nurs. 2003 Mar;41(6):528-35.
- McGee D, Del Vento A, Bavelas JB. An interactional model of questions as therapeutic interventions. J Marital Fam Ther. 2005 Oct;31(4):371-84.
- Morgan L. A decade review: methods to improve adherence to the treatment regimen among hemodialysis patients. Nephrol Nurs J. 2000 Jun;27(3):299-304. Review.
- UMH-SFNursing