Abstract
Background
Hemodialysis patients are at risk of serious health complications, yet treatment non-adherence remains high.
Purpose
Warnings about health risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory (Steele 1988) reduced patients’ resistance to health-risk information and improved adherence.
Methods
One hundred twelve patients either self-affirmed or completed a matched control task before reading about the risks associated with a lack of phosphate control. Serum phosphate was collected from baseline up to 12 months.
Results
Self-affirmed patients had significantly reduced serum phosphate levels at 1 and 12 months. However, contrary to the predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, behavioural intention or self-efficacy.
Conclusions
A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce serum phosphate over a 12 month period. Further work is required to identify mediators of the observed effects.
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Acknowledgments
The study was funded by a project grant from the British Renal Society. We wish to thank the patients and the renal unit staff for their contribution to the study.
Author’s Statement of Conflict of Interest and Adherence to Ethical Standards
Authors Vari Wileman, Ken Farrington, Joseph Chilcot, Sam Norton, David Wellsted, Michael K. Almond, Andrew Davenport, Gail Franklin, Maria Da Silva Gane, and Christopher J Armitage declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
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Wileman, V., Farrington, K., Chilcot, J. et al. Evidence That Self-Affirmation Improves Phosphate Control in Hemodialysis Patients: A Pilot Cluster Randomized Controlled Trial. ann. behav. med. 48, 275–281 (2014). https://doi.org/10.1007/s12160-014-9597-8
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DOI: https://doi.org/10.1007/s12160-014-9597-8