King's College London

Research portal

Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory based intervention: a randomised controlled trial

Research output: Contribution to journalArticle

Vari Wileman, Joseph Chilcot, Christopher J Armitage, Ken Farrington, David M Wellsted, Sam Norton, Andrew Davenport, Gail Franklin, Maria Da Silva Gane, Robert Horne, Mike Almond

Original languageEnglish
Pages (from-to)100-114
Number of pages15
JournalPsychology & health
Issue number1
Early online date6 Aug 2015
E-pub ahead of print6 Aug 2015
Published2 Jan 2016

Bibliographical note

Not freely accessible but may have access through your institution


  • Wileman_et_al_2015

    Wileman_et_al_2015.pdf, 730 KB, application/pdf

    Uploaded date:14 Dec 2015

    Version:Submitted manuscript

King's Authors


Objective Haemodialysis patients are at risk of serious health complications, yet treatment non-adherence remains high. Warnings about health-risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence. Design In a cluster randomised controlled trial, ninety-one patients either self-affirmed or completed a matched-control task before reading about the health-risks associated with inadequate fluid control. Outcome measures Patients' perceptions of the health-risk information, intention and self-efficacy to control fluid, were assessed immediately after presentation of health-risk information. Interdialytic-weight-gain (IDWG), excess fluid removed during hemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post intervention. Results Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy. Conclusion A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454