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Motivational Interviewing Promotes Adherence and Improves Wellbeing in Pre-Dialysis Patients with Advanced Chronic Kidney Disease

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Abstract

Low rates of adherence to medical treatments and adverse emotional states are a widespread problem in advanced chronic kidney disease (ACKD). Motivational interviewing using the stages of change model is an effective combination in promoting behavior modifications. The objective of the present study was to determine the effectiveness of an individual, pre-dialysis intervention program (monthly sessions of 90 min over a 6-month period) in terms of adherence, emotional state and health-related quality of life (HRQL). Forty-two patients were evaluated for adherence, depression, anxiety and HRQL with standardized self-report questionnaires. Biochemical markers were also registered. The results show that after the intervention, patients reported significantly higher levels of adherence, lower depression and anxiety levels, and better HRQL (i.e., general health and emotional role domains). Biochemical parameters were controlled significantly better after the intervention, except for iPTH. These findings highlight the potential benefit of applying individual psycho-educational intervention programs based on motivational interviewing and using the stages of change model to promote adherence and wellbeing in ACKD patients.

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Acknowledgments

This research was supported in part by unrestricted funds granted to the Nephrology Research Unit (R.S., H.G., G.D. and O.C) by the Shire Pharmaceutical Company.

Ethical Standards

All procedures followed were 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. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Nephrology Department, General Hospital, La Paz Biomedical Research Institute (IdiPAZ), La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain

    Helena García-Llana, Gloria del Peso & Olga Celadilla

  2. Faculty of Psychology, Autónoma University, Madrid, Spain

    Eduardo Remor

  3. Nephrology Department, General Hospital, La Paz Biomedical Research Institute (IdiPAZ), La Paz University Hospital and Reina Sofia Renal Diseases Research Institute (IRSIN), Madrid, Spain

    Rafael Selgas

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  1. Helena García-Llana
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Correspondence to Helena García-Llana.

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García-Llana, H., Remor, E., del Peso, G. et al. Motivational Interviewing Promotes Adherence and Improves Wellbeing in Pre-Dialysis Patients with Advanced Chronic Kidney Disease. J Clin Psychol Med Settings 21, 103–115 (2014). https://doi.org/10.1007/s10880-013-9383-y

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