The Development of Self management Support Program for Chronic Kidney Disease Patients at Pre-dialysis stage.

Abstract

Objective : To  develop   self-management  program  for chronic kidney disease patients  at  pre-dialysis stage  in chronic  kidney disease  clinic  at  Mahasarakham  hospital and  study the effect

Methods :  Research & development  as used as a methodology of his research. Participants in the study were three  groups :  1.) patients with chronic kidney disease at  pre-dialysis stage   2.) Care giver of  patients with chronic kidney disease at  pre-dialysis stage   3.) Medical care team  and  nurses who specialized in chronic kidney disease. Study duration  was between October  2016  to  Janurary  2018  and  devided  in 3 phrases  1.) Situation analysis 2.) Program  development    3.)  Program evaluation .   Research instruments included  a.) clinical record form  b.) Patient  group  discussion. Data analysis were performed by  descriptive statistic  and  information analysis.

Results :   In  situation analysis  phase , it is found that  1) on  follow up day patients  had high blood  pressure because they did  not  take  anti-hypertensive  drugs  and did not bring medication with them moreover, they adjusted dose of antihypertensive drugs by themselves  2) after receiving  education session from  health care providers , patients did not remember  the significant contents  3) loss of communication  between health care providers and caregivers  4) did not have self- management  support program for patients with chronic kidney disease at  pre-dialysis stage   Phase 2  Program  and instruments were developed by a researcher  including  self  management support program including , health education booklet , patient  skill development,  and self-monitoring patient book and telephone call monitoring Phase 3 evaluation phase , the results showed that patients  who had glomerular  filtration  rate  decreasing  less than 4 cc/min/1.73m² per year  was  78.12  percentage and patients who can control  blood  pressure ( not  more  than 140/90  mmHg) was 84.37 percentage.

Conclusion : The  self-management  support  program for chronic kidney disease patients at pre-dialysis stage is effective tool for slowing the progression of kidney disease among patients with chronic kidney disease at predialysis stage.