RESUMO
BACKGROUND: Non-adherence to fluid restrictions is common in patients maintained on hemodialysis prior to and after kidney transplantation,which has a profound influence on the development and transfer of illness of the patients.Mental factors have great influences on adherence to fluid restrictions.OBJECTIVE: To investigate the effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation.METHODS: In total 100 patients maintained on hemodialysis were randomly assigned to an intervention group(n = 50)and a control group(n = 50).The control group received the conventional therapy.At the same time,the intervention group received the conventional therapy combined with rational-emotive therapy.All cases were assessed with the Symptom Checklist 90(SCL-90)and Medical Coping Modes Questionnaire(MCMQ)prior to and after intervention.Clinical indices related to adherence to fluid restrictions were measured three successive times and the average score of each index was calculated.RESULTS AND CONCLUSION: Forty-eight patients from the intervention group and 44 patients from the control group accomplished the study.After intervention,the scores of the two subscales,confronce and avoidance,were significantly higher than those in the control group(P < 0.05).However,some scores were significantly lower than those in the control group,including the score of acceptance/resignation subscale of MCMQ,total average score of SCL-90,the score of somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,photic anxiety and additional items,and the score of four clinical indices related to adherence to fluid restrictions(the ratio of interdialysis weight gain to dry weight,mean systolic blood pressure,mean diastolic blood pressure,and mean ultrafiltration volume prior to hemodialysis)(P < 0.05).All these findings suggest that rational-emotive therapy can effectively amend the coping modes and the mental states of the patients,and then improve their adherence to fluid restrictions.