Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease

Satchina Moktan; Sirirat Leelacharas; Wonnapha Prapaipanich

doi:10.33165/rmj.2019.42.2.119901

Authors

Satchina Moktan Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand / Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
Sirirat Leelacharas Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Wonnapha Prapaipanich Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33165/rmj.2019.42.2.119901

Keywords:

Knowledge, Self-efficacy, Self-management, Chronic kidney disease

Abstract

Background: Chronic kidney disease (CKD) is an emerging global public health problem. Control of risk factors and prevention of complications can delay the progression to end-stage renal disease. Self-efficacy and self-management behavior in patients with predialysis CKD has not been investigated in Nepal.

Objectives: To describe knowledge of CKD, self-efficacy, and self-management behavior in patients with predialysis CKD and to determine the relationships between knowledge in CKD and self-efficacy with self-management behavior.

Methods: Ninety-seven predialysis CKD patients visiting nephrology clinic of a tertiary care hospital in Kathmandu, Nepal were recruited from November 2016 to December 2016. Questionnaires comprised of sociodemographic data, CKD knowledge, self-efficacy, and self-management behavior questionnaires were used. Data were analyzed, using descriptive statistics and Pearson product moment correlation coefficient.

Results: The mean age of 97 participants was 45.67 years. There were 3 stages of CKD among participants: stage G4 (54.64%), stage G3 (42.27%), and stage G2 (3.09%), respectively. Hypertension was the most common comorbidity (81.44%) followed by diabetes mellitus (30.92%). Predialysis CKD patients had a moderate level of knowledge on CKD and self-efficacy and high level of self-management behavior. There were positive relationships between knowledge in CKD and self-management behavior (r = 0.52; P < .05), and between self-efficacy and self-management behavior (r = 0.39; P < .05).

Conclusions: This study suggested that education, counseling, workshop to increase the knowledge, self-efficacy, and self-management behavior might be helpful for the predialysis CKD patients. Healthcare providers can educate, motivate, and train the patients to practice self-management behavior to delay the progression of CKD.

References

International Society of Nephrology. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease--chapter 1: definition and classification of CKD. Kidney Int Suppl. 2012;3(1):19-62. doi:10.1038/kisup.2012.1064.

International Society of Nephrology. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease--chapter 2: definition, identification, and prediction of CKD progression. Kidney Int Suppl. 2012;3(1):63-72. doi:10.1038/kisup.2012.6.

Murali R, Sathyanarayana D, Muthusethupathy MA. Assessment of quality of life in chronic kidney disease patients using the kidney disease quality of life-short form questionnaire in Indian population: a community based study. Asian J Pharm Clin Res. 2015;8(1):271-274.

Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease – a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. doi:10.1371/journal.pone.0158765.

World Health Organization. Nepal top 50 causes of death, 2014. http://www.worldlifeexpectancy.com/country-health-profile/nepal. Accessed April 5, 2019.

Hasan M, Sutradhar I, Gupta RD, Sarker M. Prevalence of chronic kidney disease in South Asia: a systematic review. BMC Nephrol. 2018;19(1):291. doi:10.1186/s12882-018-1072-5.

Abraham G, Varughese S, Thandavan T, et al. Chronic kidney disease hotspots in developing countries in South Asia. Clin Kidney J. 2016;9(1):135-141. doi:10.1093/ckj/sfv109.

Murphree DD, Thelen SM. Chronic kidney disease in primary care. J Am Board Fam Med. 2010;23(4):542-550. doi:10.3122/jabfm.2010.04.090129.

National Center for Chronic Disease Prevention and Health Promotion. National Chronic Kidney Disease Fact Sheet, 2017. https://www.cdc.gov/kidneydisease/pdf/kidney_factsheet.pdf. Accessed April 5, 2019.

The World Bank. GDP (current US$), 2016. https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=NP. Accessed April 5, 2019.

Agrawal HK, Jain D, Pawar S, Yadav RK. Health-related quality of life in different stages of chronic kidney disease. QJM. 2016;109(11):711-716. doi:10.1093/qjmed/hcw1054.

Welch JL, Johnson M, Zimmerman L, Russell CL, Perkins SM, Decker BS. Self-management interventions in stages 1-4 chronic kidney disease: an integrative review. West J Nurs Res. 2015;37(5):652-678. doi:10.1177/0193945914551007.

Havas K, Douglas C, Bonner A. Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support. BMC Nephrol. 2017;18(1):17. doi:10.1186/s12882-016-0416-2.

Zungu LI, Djumbe FR. Knowledge and lifestyle practices of hypertensive patients attending a primary health care clinic in Botswana. http://hdl.handle.net/10500/8684. Accessed April 5, 2019.

Larsan PD. Lubkin's Chronic Illness: Impact and Intervention (Lubkin, Chronic Illness). 9th ed. Burlington, MA: Jones & Bartlett Learning; 2016.

Cohen J. A power primer. Psychol Bull. 1992;112(1):155-159. doi:10.1037/0033-2909.112.1.155.

Grove S, Burns N, Gray J. The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. St. Louise, Missouri: Elsevier Saunders; 2013.

Curtin RB, Walters BA, Schatell D, Pennell P, Wise M, Klicko K. Self-efficacy and self-management behaviors in patients with chronic kidney disease. Adv Chronic Kidney Dis. 2008;15(2):191-205. doi:10.1053/j.ackd.2008.01.006.

Behling O, Law KS. Translating Questionnaires and Other Research Instruments. Thousand Oaks, CA: Sage Publications; 2000. doi:10.4135/9781412986373.

Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41. doi:10.1159/000180580.

McIntyre NJ, Fluck R, McIntyre C, Taal M. Treatment needs and diagnosis awareness in primary care patients with chronic kidney disease. Br J Gen Pract. 2012;62(597):e227-e232. doi:10.3399/bjgp12X636047.

Welch JL, Bartlett Ellis RJ, Perkins SM, et al. Knowledge and awareness among patients with chronic kidney disease stage 3. Nephrol Nurs J. 2016;43(6):513-519.

Mishra D, Koirala P. Status of chronic kidney disease patients registered in National Kidney Center, Banasthali, Kathmandu. JMMIHS. 2015;1(4):19-23. doi:10.3126/jmmihs.v1i4.11997.

Paudel YP, Dahal S, Acharya T, et al. Biochemical profile of chronic kidney disease (CKD) paitents in various age and gender group subjects visiting Kist Medical College & Teaching Hospital, Kathmandu. J Chitwan Med Coll. 2013;3(2):36-39. doi:10.3126/jcmc.v3i2.8441.

Devraj R, Borrego M, Vilay AM, Gordon EJ, Pailden J, Horowitz B. Relationship between health literacy and kidney function nephrology. Nephrology (Carlton). 2015;20(5):360-367. doi:10.1111/nep.12425.

Wright JA, Wallston KA, Elasy TA, Ikizler TA, Cavanaugh KL. Development and results of a kidney disease knowledge survey given to patients with CKD. Am J Kidney Dis. 2011;57(3):387-395. doi:10.1053/j.ajkd.2010.09.018.

Whaley-Connell A, Shlipak MG, Inker LA, et al. Awareness of kidney disease and relationship to end-stage renal disease and mortality. Am J Med. 2012;125(7):661-669. doi:10.1016/j.amjmed.2011.11.026.

Daker-White G, Rogers A, Kennedy A, Blakeman T, Blickem C, Chew-Graham C. Non-disclosure of chronic kidney disease in primary care and the limits to instrumental rationality in chronic illness self-management. Soc Sci Med. 2015;131:31-39. doi:10.1016/j.socscimed.2015.02.035.

Phua SH, Taha NA, Pau KB, Kong WY. Evaluation of self management behavior of chronic kidney disease patients. J Pharm Pharmacol. 2017;5:179-188. doi:10.17265/2328-2150/2017.04.002.

Bhandari P, Kim M. Self-care behaviors of Nepalese adults with type 2 diabetes: a mixed methods analysis. Nurs Res. 2016;65(3):202-214. doi:10.1097/NNR.0000000000000153.

National Kidney Disease Education Program (NKDEP). Chronic Kidney Disease (CDK) and Diet: Assessment, Management, and Treatment. https://www.niddk.nih.gov/-/media/Files/Health-Information/Communication-Programs/NKDEP/ckd-diet-assess-manage-treat-508.pdf. Revised April 2015. Accessed April 5, 2019.

Nutrition Services. Chronic Kidney Disease and Nutrition, 2011. https:// www.health.govt.nz/system/files/documents/topic_sheets/ckd-and-nutrition.pdf. Accessed January 24, 2019.

Burnier M, Pruijm M, Wuerzner G, Santschi V. Drug adherence in chronic kidney diseases and dialysis. Nephrol Dial Transplant. 2015;30(1):39-44. doi:10.1093/ndt/gfu015.

Sontakke S, Budania R, Bajait C, Jaiswal K, Pimpalkhute S. Evaluation of adherence to therapy in patients of chronic kidney disease. Indian J Pharmacol. 2015;47(6):668-671. doi:10.4103/0253-7613.169597.

Pagels AA, Hylander B, Alyarsson M. A multi-dimensional support programme for patients with diabetic kidney disease. J Ren Care. 2015;41(3):187-194. doi:10.1111/jorc.12114.

Qobadi M, Besharat MA, Rostami R, Rahiminezhad A. Health literacy and medical adherence in hemodialysis patients: the mediating role of disease-specific knowledge. Thrita. 2015;4(1):e26195. doi:10.25812/thrita.26195.

Shailendranath B, Ushadevi C, Kedlaya PG. Impact of knowledge, attitude and behavior among maintenance hemodialysis patients for adherence to dietary regimen - a single centre experience. Int J Humanit Soc Sci. 2014;4(12):257-262.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215.

Lorig K, Ritter PL, Villa FJ, Armas J. Community-based peer-led diabetes self-management: a randomized trial. Diabetes Educ. 2009;35(4):641-651. doi:10.1177/0145721709335006.