IMPACT of nurses' solution-focused communication on the fluid adherence of adult patients on haemodialysis

Aim: to test the hypothesis that fluid adherence in patients on haemodialysis can be improved through nurses′ solution‐focused communication with patients on issues of adherence. Background: adherence to fluid‐intake restrictions is low in patients on haemodialysis, creating serious health risks. Psychosocial interventions to increase adherence have typically focused on patients and ignored patient/staff interactions. Design: this is a single‐group, pre‐post pilot study registered in ClinicalTrials.gov (identifier: NCT03432988). Method: a 1‐month baseline of interdialytic weight gain was taken in April 2016 for a group of 36 adult patients in a hospital haemodialysis unit. Then, the nurses of the unit received a 4 hr training in solution‐focused communication on issues of fluid adherence and applied it with the patients of the sample. Interdialytic weight gains were measured during another month. One month after the training, in October 2016, interdialytic weight gains were measured for another month. Results: after introducing solution‐focused communication on fluid adherence, patients′ average interdialytic weight gains decreased significantly, below the level considered indicative of problematic adherence. These results were maintained at follow‐up. Conclusions: our results suggest that a novel approach to adherence, nurses′ solution‐focused communication with patients on haemodialysis, may improve patients′ adherence to fluid restriction. More rigorous, controlled studies are required to confirm long‐term benefits and to understand the causal mechanisms that may underlie the effectiveness of this intervention.