Factors Associated with Self-Management Behaviors for Preventing Complications in Hemodialysis Patients in Khon Kaen Province

Abstract

This cross-sectional analytical study aimed to determine the levels of knowledge, health literacy, and self-management behaviors for preventing complications, as well as factors associated with self-management behaviors in chronic kidney disease patients receiving hemodialysis. The sample consisted of 375 patients receiving hemodialysis at 5 public hospitals in Khon Kaen Province. Data were collected using validated questionnaires with established content validity and reliability. Data analysis included descriptive statistics and multiple logistic regression. Results showed that most participants were ≥60 years old (51.47%), had low knowledge levels (45.07%), problematic health literacy (54.67%), and good self-management behaviors (78.67%). Seven factors were significantly associated with self-management behaviors: gender (ORadj = 2.15, 95% CI: 1.10-4.20, p = 0.026), education level (ORadj = 2.25, 95% CI: 1.25-4.05, p = 0.007), hemodialysis frequency per week (ORadj = 2.74, 95% CI: 1.51-4.97, p = 0.001), family history of kidney disease (ORadj = 3.63, 95% CI: 1.31-10.00, p = 0.013), having a caregiver (ORadj = 1.53, 95% CI: 1.81-1.97, p = 0.001), income (ORadj = 1.99, 95% CI: 1.11-3.60, p = 0.022), and health literacy level (ORadj = 3.37, 95% CI: 1.98-6.00, p < 0.001). The study concluded that although most patients demonstrated good self-management behaviors, they had insufficient knowledge and health literacy levels. These findings can be applied to develop effective care approaches for chronic kidney disease patients, particularly through promoting health literacy, which was identified as the most significant factor.