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Fluid Intake Appraisal Inventory: development and psychometric evaluation of a situation-specific measure for haemodialysis patients' self-efficacy to low fluid intake.
Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden; Section for Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0003-1289-9896
Department of Medical Sciences, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
Section for Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
2007 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 63, no 2, 167-73 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Self-efficacy is an important determinant of health behaviour and reflects a person's belief about their capability to complete a given task. The relationship between self-efficacy and fluid adherence has been investigated, although limited attention has been given to measurement issues. The purpose of this study was to develop a measure of situation-specific self-efficacy for constructive fluid intake behaviour in haemodialysis patients, the Fluid Intake Appraisal Inventory (FIAI). Methods: Items were generated from an analysis of empirical studies available in the literature and exposed to an interpretability critique before haemodialysis patients confirmed sufficiency of each item. In a multi-centre study, data from 144 haemodialysis patients were collected regarding general self-efficacy, situation-specific self-efficacy, and estimated fluid consumption. Internal consistency, criterion-related validity, and structural validity were tested. Results: The FIAI was found to have high internal consistency (Cronbach alpha 0.96) and the theoretical assumptions for criterion-related validity and known-group validity were supported. Structural validity was not confirmed, however, because the theoretically hypothesized four-factor model was not the prime structure. Conclusion: The FIAI was revealed to have satisfactory psychometric properties. The scale may be used in research or in clinical settings to study the mediating effects of self-efficacy or to modify haemodialysis patients' fluid-intake behaviour. Although this first validity study is promising, further validation focusing on reliability and cultural validity is needed.

Place, publisher, year, edition, pages
2007. Vol. 63, no 2, 167-73 p.
Keyword [en]
chronic renal failure; Fluid Intake Appraisal Inventory; fluid restriction; psychometric properties; reliability/validity; self-efficacy
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-5331DOI: 10.1016/j.jpsychores.2007.03.013ISI: 000248644300009PubMedID: 17662753OAI: oai:DiVA.org:hig-5331DiVA: diva2:234306
Available from: 2009-09-07 Created: 2009-09-07 Last updated: 2016-10-17Bibliographically approved
In thesis
1. Excessive Fluid Overload Among Haemodialysis Patients: Prevalence, Individual Characteristics and Self-regulation of Fluid Intake
Open this publication in new window or tab >>Excessive Fluid Overload Among Haemodialysis Patients: Prevalence, Individual Characteristics and Self-regulation of Fluid Intake
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is comprised of four studies and concerns haemodialysis patients’ confidence in being able to manage fluid intake between treatment sessions, and whether the fluid intake is influenced by certain modifiable characteristics of the persons in question. The overall aim was to study aspects of excessive fluid overload and haemodialysis patients’ self-regulation of fluid allotment from a bio-psychosocial and behavioural medicine perspective.

The extent of non-adherence to fluid allotment was described in Study I. National registry data were used. Three out of ten Swedish haemodialysis patients had excessive fluid overload and one out of five was at risk for treatment related complications due to too rapid ultrafiltration rate.

The objective in Study II was to develop and psychometrically evaluate a self-administered scale to measure situation-specific self-efficacy to low fluid intake. The measure (the Fluid Intake Appraisal Inventory) was found to be reliable and valid in haemodialysis settings.

Subgroups based on individual profiles of self-efficacy, attentional style and depressive symptoms were explored in Study III using a cluster analytic approach. Three distinct subgroups were found and the subgroup structure was validated for clinical relevance. The individuals’ profile concerning self-efficacy, attentional style and depressive symptoms has to be taken into account in nursing interventions designed to reduce haemodialysis patients’ fluid intake.

In Study IV, an intervention designed to reduce haemodialysis patients’ fluid intake was introduced and its acceptability, feasibility and efficacy were evaluated and discussed. Acceptability of such an intervention was confirmed. Addressing beliefs, behaviours, emotions and physical feelings is clinically feasible and may reduce haemodialysis patient’s excessive fluid overload.

This thesis indicates that there is a potential for improvement in the fluid management care of haemodialysis patients. Behavioural nursing strategies that aim to assist patients to achieve fluid control should be applied more extensively. Cognitive profiles of the patients should be taken into account when targeted nursing intervention aiming to encourage and maintain the patient’s fluid control is introduced.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 89 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 551
Keyword
Behavioural medicine, fluid overload, adherence, haemodialysis, self-efficacy, attentional style, depressive symptomatology, cluster analysis, tailored treatment, quasi-experimental single-case design, Fluid Intake Appraisal Inventory (FIAI), renal nursing
National Category
Urology and Nephrology Nursing
Research subject
Medical Science; Caring Sciences
Identifiers
urn:nbn:se:hig:diva-12752 (URN)978-91-554-7782-0 (ISBN)
Public defence
2010-05-19, Sal IV, Universitetshuset, Övre Slottsgatan 2, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-08-31 Created: 2012-08-31 Last updated: 2015-07-01Bibliographically approved

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