Effectiveness of the Nurse-led Self and Family Management Support Program among Adults with Early-stage Chronic Kidney Disease: A Randomized Controlled Trial

Authors

  • Rostikorn Khwanchum Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Linchong Pothiban Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Tipaporn Wonghongkul Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Sumalee Lirtmulikaporn Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.264735

Keywords:

Disease knowledge, Early-stage chronic kidney disease, Family support, Nursing practice, Self-management

Abstract

Chronic kidney disease is a significant health problem that leads to severe complications and premature death. Adults with early-stage chronic kidney disease need to maintain renal function and prevent the progression, which can be achieved through effective self-management. This randomized control trial with a two-arm pre-post-test aimed to investigate the effectiveness of the Nurse-led Self and Family Management Support Program for increasing disease knowledge and self-management among adults with early-stage chronic kidney disease. The sample consisted of dyads of 64 adults with the disease and their family members. The dyads were randomly assigned to the experimental arm (n = 32) and the control arm (n = 32). The experimental arm received the Nurse-led Self and Family Management Support Program, while the control arm received only usual care. Data was collected using a demographic data recording form, the Disease Knowledge Scale, and the Chronic Kidney Disease Self-Management Scale. Data analysis was undertaken using descriptive statistics, two-way repeated ANOVA with post hoc test, and independent t-test.

From the results, the participants in the experiment arm had better disease knowledge and self-management than the control group at 4, 8, and 12 weeks after the program and were better than before the program. Nurses can apply this program to encourage individuals and family members to be involved in providing all aspects of support for self-management for adults with early-stage chronic kidney disease. However, further testing in other settings is needed.

References

GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2020; 395: 709–33. doi:10.1016/S0140-6736(20)30045-3.

Carney EF. The impact of chronic kidney disease on global health. Nat Rev Nephrol. 2020; 16(5): 251. doi:10.1038/s41581-020-0268-7.

Shrestha N, Gautam S, Mishra SR, Virani SS, Dhungana RR. Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis. PLoS One. 2021;16(10):e0258494. doi: 10.1371/journal.pone.0258494.

Bureau of Non-Communicable Diseases, Department of Disease Control of Thailand. Annual report 2022. Bangkok: Aksorn Graphic and Design Publishing; 2022.

Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2020; 98(4S): S1–S115.

Tsai YC, Wang SL, Tsai HJ, Chen TH, Kung LF, Hsiao PN, et al. The interaction between self-care behavior and disease knowledge on the decline in renal function in chronic kidney disease. Sci Rep. 2021; 11(1):401. doi: 10.1038/s41598-020-79873-z.

Paypat S, Pakdevong N, Binhosen V. The association among knowledge, self-efficacy and self-management behaviors in patients with chronic kidney disease. APHEIT J Nurs Health. 2021; 3(2): 22–36.

Vesga JI, Cepeda E, Pardo CE, Paez S, Sanchez R, Sanabria RM. Chronic kidney disease progression and transition probabilities in a large preventive cohort in Colombia. Int J Nephrol. 2021; 2021: 8866446. doi: 10.1155/2021/8866446.

Okoro RN, Ummate I, Ohieku JD, Yakubu S, Adibe MO, Okonta MJ. Kidney disease knowledge and its determinants among patients with chronic kidney disease. J Patient Exp. 2020;7(6):1303-09. doi: 10.1177/2374373520967800.

Fiseha T, Tamir Z. Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia. BMC Nephrol. 2020; 21(1): 129. doi: 10.1186/s12882-020-01768-y.

Sorat W. Predictors of quality of life in Thai adults with early-stage chronic kidney disease [Dissertation]. [Lowell, Massachusetts]: University of Massachusetts Lowell; 2019.

Cui Y, Yang T, Li R, Wang H, Jin S, Liu N, et al. Network structure of family function and self-management in patients with early chronic kidney disease amid the COVID-19 pandemic. Front Public Health. 2023;10:1-11. doi: 10.3389/fpubh.2022.1073409.

Kalantar-Zadeh K, Li PK, Tantisattamo E, Kumaraswami L, Liakopoulos V, Lui SF, et al. Living well with kidney disease by patient and care-partner empowerment: kidney health for everyone everywhere. Can J Kidney Health Dis. 2021; 8:1-7. doi: 10.1177/2054358121995276.

Parel JT, Negi L, Thomas L. Living well with kidney disease: nurses make a huge difference. IJNEN.2021;7(2). doi:10.37628/IJNeN.

Ryan P, Sawin KJ. The Individual and Family Self-Management Theory: background and perspectives on context, process, and outcomes. Nurs Outlook. 2009;57(4):217-25. doi: 10.1016/j.outlook.2008.10.004.

House JS. Work stress and social support. Reading: Addison-Wesley; 1981.

Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7. doi:10.1207/S15324796ABM2601_01.

Du Y, Dennis B, Ramirez V, Li C, Wang J, Meireles CL. Experiences and disease self-management in individuals living with chronic kidney disease: qualitative analysis of the National Kidney Foundation's online community. BMC Nephrol. 2022;23(1):1-10. doi: 10.1186/s12882-022-02717-7.

van Hooft SM, Been-Dahmen JMJ, Ista E, van Staa A, Boeije HR. A realist review: what do nurse-led self-management interventions achieve for outpatients with a chronic condition? J Adv Nurs. 2017; 73(6):1255-71. doi: 10.1111/jan.13189.

Bulto LN, Roseleur J, Noonan S, Pinero de Plaza MA, Champion S, Dafny HA, et al. Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: a systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2023. doi: 10.1093/eurjcn/zvad040.

Zala P, Rütti G, Arampatzis S, Spichiger E. Experiences of patients with chronic kidney disease and their family members in an advanced practice nurse-led counseling service. Nephrol Nurs J. 2017; 44(6): 521-43.

Peng S, He J, Huang J, Lun L, Zeng J, Zeng S, et al. Self-management interventions for chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol. 2019; 20(1):142. doi: 10.1186/s12882-019-1309-y.

Chosivasakul K, Piaseu N, Sakdanupab S. Effects of a programme integrating multidisciplinary approach and self-management on chronic kidney disease patients with complications. JTNMC. 2017;32:79–93.

Thongyost P, Malathum P, Pookboonmee R, Detprapon M, Satitvipawee P, Somboonthanakij S. Effectiveness of a self- and family management support program among older people with diabetic retinopathy and visual impairment: a randomized controlled trial. Pacific Rim Int J Nurs Res. 2023;27(1):105-20. doi: 10.60099/prijnr.2023.260336.

Maneesri S, Masingboon K, Chaimongkol N. Effectiveness of individual and family self-management combined mHealth program for people with stage 3 chronic kidney disease: a randomized controlled trial. Pacific Rim Int J Nurs Res. 2023;27(1):169-84. doi: 10.60099/prijnr.2023.260340.

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

Best J. Research in education. New Jersey: Prentice Hall; 1977.

Lin CC, Wu CC, Anderson RM, Chang CS, Chang SC, Hwang SJ, et al. The chronic kidney disease self-efficacy (CKD-SE) instrument: development and psychometric evaluation. Nephrol Dial Transplant. 2012;27(10):3828-34. doi: 10.1093/ndt/gfr788.

Photharos N, Wacharasin C, Duongpaeng S. Model of self-management behavior in people experiencing early-stage chronic kidney disease. Pacific Rim Int J Nurs Res. 2018; 22(4): 360-71.

Plichta SB, Kelvin EA, Munro BH. Munro’s statistical methods for health care research. Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins; 2012.

Juntachat A, Meepan M, Jabprapai P. The development of the self-management program for diabetes mellitus patients with third stage chronic kidney disease. JPMAT. 2017; 7(3): 280–91.

Viet Hung N, Chamroonsawasdi K, Vatanasomboom P, Chottanapund S. Effectiveness of a family support coaching program on diabetes mellitus self-management to improve health outcomes among Thai patients with uncontrolled type 2 diabetes: a quasi-experimental study. J Public Hlth Dev. 2020; 18(3): 64–83.

Chaiyasung P, Jukchai P, Sridet R, Nanudorn A. The development of self-care promotion program on behavior self-care of chronic disease patients with chronic kidney disease at home. J Nurs Educ. 2020;13(1):27–42.

Ozieh MN, Egede LE. A lifestyle intervention to delay early chronic kidney disease in African Americans with diabetic kidney disease: pre-post pilot study. JMIR Form Res. 2022;6(3):e34029. doi: 10.2196/34029.

Schrauben SJ, Rivera E, Bocage C, Eriksen W, Amaral S, Dember LM, et al. A qualitative study of facilitators and barriers to self-management of CKD. Kidney Int Rep. 2021;7(1):46-55. doi: 10.1016/j.ekir.2021.10.021.

Bandura A. Social cognitive theory of self-regulation. Organ Behav Hum Decis Process. 1991;50(2):248–87. doi: 10.1016/0749-5978(91)90022-L.

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Published

2023-12-21

How to Cite

1.
Khwanchum R, Pothiban L, Wonghongkul T, Lirtmulikaporn S. Effectiveness of the Nurse-led Self and Family Management Support Program among Adults with Early-stage Chronic Kidney Disease: A Randomized Controlled Trial. PRIJNR [Internet]. 2023 Dec. 21 [cited 2024 May 14];28(1):219-33. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/264735