Effects of Self-Monitoring and Monetary Reward on Fluid Adherence among Adult Hemodialysis Patients

The effects of a monetary reward and self-monitoring on reducing interdialytic weight gain (IWG) were compared for 6 hemodialysis patients in an outpatient setting. A single-subject experimental design (A-B-BC-B-BC) was used to examine each variable individually and in combination, with alternating phases to control for possible sequencing effects. Monetary reward (50 cents - $3) was administered in a titrated manner according to standardized criteria, ranging from 3 % and 4% of patients' dry weight on weekdays and weekends, respectively, to 3.5% and 4.5% for weekdays and weekends. Self-monitoring involved recording daily fluid and diet intake. Results indicated that by the end of the treatment program, the 6 participants averaged a 14% reduction in weekday IWG and a 15.45% reduction in weekend IWG; however, due to significant variability, it cannot be concluded that the reductions are treatment effects. Four out of 6 participants reduced their average IWG for both weekends and weekdays by .75 kg (1.65 lb.). The average weekend reduction for these 4 participants was .85 kg (1.87 lbs.) while the average weekday reduction was .65 kg (1.43 lb.). All 6 participants showed reductions in weekday IWG that averaged .53 kg (1.17 lb.). However, only 2 participants demonstrated IWG reductions that could be attributable to either of the 2 treatment variables. The standardized dry weight criterion for assessing fluid adherence may have posed excessively stringent demands on participants, as only 1 of the 6 participants actually met the criterion. Future research should address the role of nonspecific treatment factors, as well as patient characteristics and responsivity to particular treatment components in an effort to identify those factors responsible for behavior change in this population.

Grantor dc:publisher

University of North Texas

Year dc:date

2000

Author dc:creator

• Sonnier, Bridget L.

Contributors dc:contributor

• Glenn, Sigrid S., 1939-
• Ellis, Janet
• Kelly, Kimberly S.
• Lambert, Paul

• Hemodialysis -- Patients -- Psychology.
• Weight gain.
• Incentive (Psychology)
• fluid adherence
• hemodialysis
• self-monitoring
• Interdialytic weight gain
• monetary reward

Statement dc:rights

• Public
• Copyright
• Sonnier, Bridget L.
• Copyright is held by the author, unless otherwise noted. All rights reserved.

Language dc:language

English

Identifier

oclc: 47747821
https://digital.library.unt.edu/ark:/67531/metadc2693/
ark: ark:/67531/metadc2693

OAI identifier oai:identifier

info:ark/67531/metadc2693