Effects of Counseling and Educational Program based on Motivational Interviewing on Health Behaviors and Clinical Outcomes in Patient with Pre-dialysis Chronic Kidney Disease
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Published:
Dec 19, 2018
Keywords:
counseling and educational program motivational interviewing health behavior clinical outcomes patient with chronic kidney disease
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Abstract
Appropriate health behavior is necessary for patients with advanced chronic kidney disease in delaying disease progression and preventing complications. This one-group quasi-experimental research with repeated measures at 3 and 6 month aimed at evaluating the effects of motivational interviewing based counseling and educational program by an advanced practice nurse in nephrology on health behaviors, and clinical outcomes. Examples were 35 patients with pre-dialysis chronic kidney disease which purposively recruited from CKD clinic at a super tertiary care hospital. The 24-week-program had 3 phases: 1) building motivation, 2) commitments to change and 3) compliance and maintenance. Research instruments were: Personal Data Questionnaire, Health Behavior Changed Record, CKD Knowledge and Health Behavior Questionnaire, Morisky-Medication Adherence Scale (Thai), and EQ-5D quality of life (Thai). Data were analyzed by descriptive statistics, repeated measure ANOVA with Bonferroni test and Friedman test with Wilcoxon signed rank test.
Results showed that the subjects had significantly increased in scores of CKD knowledge, health behaviors, and medication adherence (p < .05). The clinical outcomes showed, the serum bicarbonate was increased, while the Systolic blood pressure, Diastolic blood pressure, and serum levels of Potassium, Phosphate, Uric acid, Fasting blood glucose, and Glycosylated hemoglobin were decreased significantly at 6 month of the program (p < .05). It is suggested that the counseling program led by advanced practice nurse should be used as guideline of care for patients with chronic kidney disease in order to slow the progression of the disease.
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เทียนสอาด จ., กนกสุนทรรัตน์ น., & กิติยากร ช. (2018). Effects of Counseling and Educational Program based on Motivational Interviewing on Health Behaviors and Clinical Outcomes in Patient with Pre-dialysis Chronic Kidney Disease. Thai Journal of Nursing and Midwifery Practice, 5(2), 19–38. Retrieved from https://he02.tci-thaijo.org/index.php/apnj/article/view/160916
Section
Research Article
References
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9. Satee A. Behaviors and factors related to sodium and protein control of chronic kidney disease patients at pre renal replacement therapy stage. [Thesis]. Khon Kaen: Khon Kaen University; 2011 (in Thai)
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12. Lopez-Vargas PA, Tong A, Howell M, Craig JC. Educational interventions for patients with CKD: a systematic review. Am J Kidney Dis. 2016 Sep 1;68(3):353-70.
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15. Dhondup T. & Qian Q. Electrolyte and acid-base disorders in chronic kidney disease and end-stage kidney failure. Blood Purif 2017;43:179-188.
16. Nokkaew J. Effect of motivation-enhancing nursing program for yoga practice on body mass index and blood sugar of overweight type 2 diabetic patients. [Thesis]. Songkhla: Prince of Songkla University; 2015. (in Thai)
17. Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C, et al. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns 2013;93(2):157-68.
18. Ma C, Zhou Y, Zhou W, Huang C. Evaluation of the effect of motivational interviewing counselling on hypertension care. Patient Educ Couns 2014;95(2):231-7.
19. Ren Y, Yang H, Browning C, Thomas S, Liu M. Therapeutic effects of motivational interviewing on blood pressure control: a meta-analysis of randomized controlled trials. Int J Cardiol 2014;172(2):509-11.
20. Van Zuilen AD, Wetzels JF, Bots ML, Van Blankestijn PJ. MASTERPLAN: study of the role of nurse practitioners in a multifactorial intervention to reduce cardiovascular risk in chronic kidney disease patients. J Nephrol 2008;21(3):261-7.
21. Prakash S, McGrail A, Lewis SA, Schold J, Lawless ME, Sehgal AR, et al. Behavioral stage of change and dialysis decision-making. Clin J Am Soc Nephrol 2015;10(2):197-204.
22. Goovaerts T, Bagnis Isnard C, Crepaldi C, Dean J, Melander S, Mooney A, et al. Continuing education: preparing patients to choose a renal replacement therapy. J Ren Care 2015;41(1):62-75.
23. Miller WR, Rollnick S. Motivational interviewing: preparing people for change, ed 2. New York, Guilford Press, 2002.
24. Prochaska JO, DiClemente CC. In search of how people change: Applications to addictive behaviors. Am Psychol 1992;47:1102-1114.
25. Intarasombat P, Sirapo-ngam Y, Chansirikarn S, Yamvong C, Mahakayanun S. Effects of patient and families participation in health care on functional outcome, well-being, complications, length of stay in elderly patients, and patient and family satisfaction with care. Rama Nur J. 1996;2(2):30-48. (in Thai)
26. Sangchanchai P. Training course manual: motivational interviewing and motivational enhancement therapy: MI & MET. 1st ed. Chaingmai: Wanida Publishers; 2010. (in Thai)
27. Singprasert R, Kanogsunthornrat N, Chailimpamontri W. Effect of behavior modification program led by advanced practice nurse on clinical outcomes in patients with pre-dialysis chronic kidney disease. Thai Journal of Nursing and Midwifery Practice. 2018; 5(1): 57-74.
28. Duangjai P. Effects of self-management promotion program on medication adherence among older adults with chronic kidney disease. [Thesis]. Chonburi: Burapha University; 2013 (in Thai)
29. Pattanaphesaj J. Health-related quality of life measure (EQ-5D-5L): measurement property testing and its preference-based score in Thai population [Doctoral dissertation]: Mahidol University; 2014. (in Thai)
30. Devraj R, Borrego ME, Vilay AM, Pailden J, Horowitz B. Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice. World J Nephrol. 2018;7(1):41.
31. Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G. Relationship between patients’ knowledge and medication adherence among patients with hypertension. Patient Prefer Adherence. 2016;10:2437.
32. Oliveria SA, Chen RS, McCarthy BD, Davis CC, Hill MN. Hypertension knowledge, awareness, and attitudes in a hypertensive population. J Gen Intern Med. 2005 Mar;20(3):219-25.
33. Lopez-Vargas PA, Tong A, Howell M, Craig JC. Educational interventions for patients with CKD: a systematic review. Am J Kidney Dis. 2016 Sep 1;68(3):353-70.
34. Lei CC, Lee PH, Hsu YC, Chang HY, Tung CW, Shih YH, Lin CL. Educational intervention in CKD retards disease progression and reduces medical costs for patients with stage 5 CKD. Ren fail. 2013 Feb 1;35(1):9-16.
35. Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23(1):19-28.
36. Jesky MD, Dutton M, Dasgupta I, Yadav P, Ng KP, Fenton A, et al. Health-related quality of life impacts mortality but not progression to end-stage renal disease in pre-dialysis chronic kidney disease: a prospective observational study. PloS one. 2016;11(11):e0165675.
2. Ingsathit A, Thakkinstian A, Chaiprasert A, Sangthawan P, Gojaseni P, Kiattisunthorn K, et al. Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study. Nephrol Dial Transplant 2010;25(5):1567-75.
3. Cooney N. Literature Review: The current situation and care model of non-communicable diseases. Nonthaburi: Art Qualified; 2014. (in Thai)
4. Almutary H, Bonner A, Douglas C. Which patients with chronic kidney disease have the greatest symptom burden? a comparative study of advanced CKD stage and dialysis modality. J Ren Care 2016;42(2):73-82.
5. Wetmore JB, Peng Y, Jackson S, Matlon TJ, Collins AJ, Gilbertson DT. Patient characteristics, disease burden, and medication use in stage 4-5 chronic kidney disease patients. Clin Nephrol 2016;85(2):101-11.
6. Powe NR. Health-related quality of life in CKD-advancing patient-centered research to transform patient care. Clin J Am Soc Nephrol 2016;11(7):1123-4.
7. Garcia-Llana H, Remor E, del Peso G, Celadilla O, Selgas R. Motivational interviewing promotes adherence and improves wellbeing in pre-dialysis patients with advanced chronic kidney disease. J Clin Psychol Med Settings 2014;21(1):103-15.
8. Onsangngam P. Results of nutrition education for chronic renal failure patients on hemodialysis. [Thesis]. Bangkok: Ramkhamheang University; 2007 (in Thai)
9. Satee A. Behaviors and factors related to sodium and protein control of chronic kidney disease patients at pre renal replacement therapy stage. [Thesis]. Khon Kaen: Khon Kaen University; 2011 (in Thai)
10. Thompson-Martin Y., McCullough PA., & Agrawal V. Impact of an educational program for advanced practice nurses on knowledge of kidney disease outcomes quality initiative guidelines. Nephrol Nurs J 2015;42(5), 455-460,496,461.
11. Ounsrimuang K., Siriwatanamethanon J., & Buatee S. Effects of self–management program on knowledge, self–management, and health indicators among patients with chronic kidney disease stage 3. Journal of Nursing and Health care 2013;31(2):91-99. (in Thai)
12. Lopez-Vargas PA, Tong A, Howell M, Craig JC. Educational interventions for patients with CKD: a systematic review. Am J Kidney Dis. 2016 Sep 1;68(3):353-70.
13. Ishani A, Christopher J, Palmer D, Otterness S, Clothier B, Nugent S, et al. Telehealth by an interprofessional team in patients with CKD: A Randomized Controlled Trial. American Journal of Kidney Diseases. 2016;68(1):41-9.
14. Nephrology Society of Thailand. Clinical practice recommendation for the evaluation and management of chronic kidney disease in adults 2015. Bangkok: Nephrology Society of Thailand; 2015. (in Thai)
15. Dhondup T. & Qian Q. Electrolyte and acid-base disorders in chronic kidney disease and end-stage kidney failure. Blood Purif 2017;43:179-188.
16. Nokkaew J. Effect of motivation-enhancing nursing program for yoga practice on body mass index and blood sugar of overweight type 2 diabetic patients. [Thesis]. Songkhla: Prince of Songkla University; 2015. (in Thai)
17. Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C, et al. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns 2013;93(2):157-68.
18. Ma C, Zhou Y, Zhou W, Huang C. Evaluation of the effect of motivational interviewing counselling on hypertension care. Patient Educ Couns 2014;95(2):231-7.
19. Ren Y, Yang H, Browning C, Thomas S, Liu M. Therapeutic effects of motivational interviewing on blood pressure control: a meta-analysis of randomized controlled trials. Int J Cardiol 2014;172(2):509-11.
20. Van Zuilen AD, Wetzels JF, Bots ML, Van Blankestijn PJ. MASTERPLAN: study of the role of nurse practitioners in a multifactorial intervention to reduce cardiovascular risk in chronic kidney disease patients. J Nephrol 2008;21(3):261-7.
21. Prakash S, McGrail A, Lewis SA, Schold J, Lawless ME, Sehgal AR, et al. Behavioral stage of change and dialysis decision-making. Clin J Am Soc Nephrol 2015;10(2):197-204.
22. Goovaerts T, Bagnis Isnard C, Crepaldi C, Dean J, Melander S, Mooney A, et al. Continuing education: preparing patients to choose a renal replacement therapy. J Ren Care 2015;41(1):62-75.
23. Miller WR, Rollnick S. Motivational interviewing: preparing people for change, ed 2. New York, Guilford Press, 2002.
24. Prochaska JO, DiClemente CC. In search of how people change: Applications to addictive behaviors. Am Psychol 1992;47:1102-1114.
25. Intarasombat P, Sirapo-ngam Y, Chansirikarn S, Yamvong C, Mahakayanun S. Effects of patient and families participation in health care on functional outcome, well-being, complications, length of stay in elderly patients, and patient and family satisfaction with care. Rama Nur J. 1996;2(2):30-48. (in Thai)
26. Sangchanchai P. Training course manual: motivational interviewing and motivational enhancement therapy: MI & MET. 1st ed. Chaingmai: Wanida Publishers; 2010. (in Thai)
27. Singprasert R, Kanogsunthornrat N, Chailimpamontri W. Effect of behavior modification program led by advanced practice nurse on clinical outcomes in patients with pre-dialysis chronic kidney disease. Thai Journal of Nursing and Midwifery Practice. 2018; 5(1): 57-74.
28. Duangjai P. Effects of self-management promotion program on medication adherence among older adults with chronic kidney disease. [Thesis]. Chonburi: Burapha University; 2013 (in Thai)
29. Pattanaphesaj J. Health-related quality of life measure (EQ-5D-5L): measurement property testing and its preference-based score in Thai population [Doctoral dissertation]: Mahidol University; 2014. (in Thai)
30. Devraj R, Borrego ME, Vilay AM, Pailden J, Horowitz B. Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice. World J Nephrol. 2018;7(1):41.
31. Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G. Relationship between patients’ knowledge and medication adherence among patients with hypertension. Patient Prefer Adherence. 2016;10:2437.
32. Oliveria SA, Chen RS, McCarthy BD, Davis CC, Hill MN. Hypertension knowledge, awareness, and attitudes in a hypertensive population. J Gen Intern Med. 2005 Mar;20(3):219-25.
33. Lopez-Vargas PA, Tong A, Howell M, Craig JC. Educational interventions for patients with CKD: a systematic review. Am J Kidney Dis. 2016 Sep 1;68(3):353-70.
34. Lei CC, Lee PH, Hsu YC, Chang HY, Tung CW, Shih YH, Lin CL. Educational intervention in CKD retards disease progression and reduces medical costs for patients with stage 5 CKD. Ren fail. 2013 Feb 1;35(1):9-16.
35. Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23(1):19-28.
36. Jesky MD, Dutton M, Dasgupta I, Yadav P, Ng KP, Fenton A, et al. Health-related quality of life impacts mortality but not progression to end-stage renal disease in pre-dialysis chronic kidney disease: a prospective observational study. PloS one. 2016;11(11):e0165675.