Stage of change and health belief model constructs related to fluid restriction in maintenance hemodialysis subjects.

摘要

The purpose of the study was to test validity of, and agreement between three methods of stage of change (SOC), and to test the reliability and validity of health belief model (HBM) constructs related to fluid restriction in maintenance hemodialysis (MHD) subjects. This was a cross sectional observational study in which subjects completed a 69-item questionnaire about fluid knowledge, SOC and HBM. The three SOC methods of staging were: 1) intention only, 2) intention and interdialytic weight gain (IDWG) in kg/day, 3) intention and IDWG as percent of dry weight. Seventy percent, 6 % and 83 % of the subjects were in action/maintenance using method I, 2, and 3, respectively. There was no agreement between method 1 of staging and method 2 (kappa = 0.057, P = 0.169) or method 3 (kappa = 0.133, P = 0.227). There were no significant differences in HBM scores between pre-action and action stage by any of the SOC methods. Participants in pre-action by method 3 were significantly younger (49 years) than those in action (59 years, P = 0.041). Blacks (82 %) versus other races (18 %), were more likely to be in action (P = 0.020). Men had a significantly higher susceptibility score than women (28 versus 24, P = 0.014). It cannot be concluded that the SOC methods or the HBM scales measured these constructs in this sample. More research is needed before a reliable valid tool to measure SOC and HBM can be used in MHD population.