Factors Associated with Self-Management among Hemodialysis Patients and Research Instruments: An Integrative Review
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Abstract
Introduction: This integrative review aims to synthesize research on factors associated with self-management among patients undergoing hemodialysis. Relevant studies were searched from CINAHL Complete, PubMed, Wiley, ScienceDirect, Google Scholar, and Thai Journals Online (ThaiJO) published between 2018 and 2025. A total of nine full-text research articles were selected based on the Joanna Briggs Institute (JBI) criteria. Results: The findings indicate that factors with a low level of association with self-management among hemodialysis patients include knowledge about hemodialysis, anxiety, and access to healthcare services. Factors demonstrating moderate to high levels of association include knowledge of chronic kidney disease related to complication control and the effects of hemodialysis, social support, health literacy, psychological resilience, social capital, patient empowerment, self-efficacy, sense of coherence, family functioning, self-regulation, and depression. Conclusion: Factors with low levels of association should be further examined in studies exploring relationships with self-management among hemodialysis patients in different contexts or among newly initiated hemodialysis patients who may demonstrate different levels of self-management. Factors with moderate to high levels of association can be applied in predictive studies and intervention-based research to enhance self-management among patients undergoing hemodialysis. In addition, the Hemodialysis Self-Management Instrument is suitable for patients aged 18 years and older and can be applied across different theoretical frameworks.
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