Self Monitoring of Dietary and Fluid Intake Using a PDA

描述(由申请人提供)：血液透析患者的成功治疗取决于他们自我监控复杂和限制性的饮食和液体方案的能力。然而，患者几乎没有工具来帮助他们跟踪或记录他们的饮食和液体摄入量，而且往往是不遵守的。只有少数研究在这一人群中进行了促进遵守饮食和液体限制的研究，而且通常这项研究没有理论基础，也不容易应用于实践。这项拟议的研究的中心目标是基于班杜拉的社会认知理论，开发和试点一种电子自我监测干预措施，旨在促进血液透析患者遵守饮食和液体限制。一旦开发出来，这种干预措施将在实践环境中由血液透析患者进行有效性和可用性的初步测试。建议的研究为期两年。在第一年，我们将使用参与式设计方法反复开发计算机程序和图形界面。在第二年，我们会试行测试电子系统的成效，并评估其可用性。在试点研究期间，20名受试者将使用PDA和集成的通用产品代码扫描仪对饮食和液体摄入量进行为期6周的电子自我监测；另外20名注意力控制组参与者将接受通常的护理。我们将在自我监测期间收集饮食和液体摄入量数据。我们将在基线数据收集前2周收集透析间体重增加数据，并在整个研究过程中继续确定总体有效性。在基线、自我监测结束时和自我监测后8周收集与中介变量有关的数据，以确定自我监测对这些变量的影响。将使用参数统计方法来分析数据。这项研究是开发电子自我监测系统的第一步，该系统有可能改善这些患者的生活质量，并降低与昂贵的急诊室就诊或因饮食或液体不坚持而额外的透析疗程相关的成本。这项研究的数据将用于开发一项大型随机对照试验，以评估干预的有效性。

DESCRIPTION (provided by applicant): Successful treatment of hemodialysis patients depends upon their ability to self-monitor complex and restrictive dietary and fluid regimens. Patients, however, are given few tools to help them track or record their dietary and fluid intake and often are nonadherent. Only a few studies have been conducted to promote adherence to dietary and fluid restrictions in this population and often this research was not theory-based or easily applied to practice. The central aims of the proposed study, based on Bandura's social-cognitive theory, are to develop and pilot test an electronic self-monitoring intervention designed to promote adherence to dietary and fluid restrictions in hemodialysis patients. Once developed, the intervention will be pilot tested for effectiveness and usability by hemodialysis patients in the practice setting. The duration of the proposed study is 2 years. During year 1, we will iteratively develop the computer program and graphical interface using the participatory design approach. During year 2 we will pilot test the effectiveness and assess the usability of the electronic system. During the pilot study, a sample of 20 individuals will electronically self-monitor diet and fluid intake for 6 weeks using a PDA and an incorporated Universal-Product-Code scanner; an additional 20 attention control participants will receive usual care. We will collect dietary and fluid intake data throughout the self-monitoring period. We will collect interdialytic weight gain data 2 weeks before baseline data collection and continue throughout the study to determine overall effectiveness. Data related to the mediating variables will be collected at baseline, at the end of selfmonitoring, and 8 weeks after self-monitoring to determine the influence of self-monitoring on these variables. Parametric statistical methods will be used to analyze data. This study is the first step in the development of an electronic self-monitoring system that has the potential for improving quality of life in these patients and decreasing costs associated with costly emergency room visits or extra dialysis sessions resulting from dietary or fluid nonadherence. Data from this study will be used in developing a large randomized controlled trial to evaluate the intervention's effectiveness.