Effects of Peer Support Program on Self-Management in Patients with End-Stage Renal Disease Undergoing Hemodialysis

*Fida' Husain orcid  -  'Aisyiyah University of Surakarta, Indonesia
Henni Kusuma orcid  -  Universitas Diponegoro, Indonesia
Andrew Johan orcid  -  Universitas Diponegoro, Indonesia
Received: 13 Nov 2019; Revised: 20 Aug 2020; Accepted: 21 Aug 2020; Published: 27 Aug 2020.
Open Access Copyright (c) 2020 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: End-stage renal disease (ESRD) patients undergoing hemodialysis require essential self-management to lifestyle changes to minimize the risk of complications, morbidity, and mortality. Efforts made to improve self-management of hemodialysis patients in previous studies were carried out by health workers that may not provide 'real' knowledge, while peer support programs carried out by patients as peers to share their experiences may provide more benefits.

Purpose: The purpose of this study was to determine the effects of peer support programs on improving self-management in patients with ESRD undergoing hemodialysis.

Methods: This study employed a quasi-experimental design and involved a total of 33 patients in the control group and 32 patients in the intervention group, who met the inclusion and exclusion criteria. The samples were recruited consecutively. The intervention of peer support programs was implemented through information support, emotional support, and mutual reciprocity in groups of 10-12 people to share experiences related to their self-management. The intervention was given for six sessions; each lasted for 30-45 minutes. The data were collected using the Indonesian version of the hemodialysis self-management instrument (HDSMI) and analyzed using a paired-sample t-test and independent-sample t-test.

Results: The results showed that after the intervention, the mean score of self-management in the intervention group increased from 79.47±7.919 to 90.75±7.089, and in the control group, the mean increased from 81.88±8.291 to 82.12±7.692. After the implementation of peer support programs, there was a significant difference in the score of self-management between the intervention and control groups (p<0.001).

Conclusion: Peer support programs gave an effect on increasing self-management in patients with ESRD undergoing hemodialysis. Peer support programs should be introduced early to ESRD patients undergoing hemodialysis so that they can learn about self-management from other patients.

 


 

Keywords: Chronic kidney disease; end-stage renal disease; hemodialysis; peer support; peer group; self-management

Article Metrics:

  1. Astuti, P. (2016). Determinan yang berhubungan dengan self management pasien gagal ginjal terminal yang menjalani hemodialisis di Kota Bekasi [Determinants related to self-management in end stage renal disease patients undergoing hemodialysis in Bekasi City] (Master's thesis). Universitas Indonesia
  2. Chen, Y., Chang, L., Liu, C., Ho, Y., Weng, S. C., & Tsai, T. I. (2018). The roles of social support and health literacy in self-management among patients with chronic kidney. Journal of Nursing Scholarship, 50(3), 1-11. doi: 10.1111/jnu.12377
  3. Cozzolino, M., Mangano, M., Stucchi, A., Ciceri, P., Conte, F., & Galassi, A. (2018). Cardiovascular disease in dialysis patients. Nephrology Dialysis Transplantation, 33, iii28–iii34. doi: 10.1093/ndt/gfy174
  4. Gela, D., & Mengistu, D. (2018). Self-management and associated factors among patients with end-stage renal disease undergoing hemodialysis at health facilities in Addis Ababa, Ethiopia. International Journal of Nephrology and Renovascular Disease, 11, 329-336. doi: 10.2147/IJNRD.S184671
  5. Guney, I., Atalay, H., Solak, Y., Altintepe, L., Zeki Tonbul, H., & Turk, S. (2012). Poor quality of life is associated with increased mortality in maintenance hemodialysis patients: a prospective cohort study. Saudi Journal of Kidney Diseases and Transplantation, 23(3), 493-499. doi: 10.4103/1319-2442.95764
  6. Haidari, A., Moeini, M., & Khosravi, A. (2017). The impact of peer support program on adherence to the treatment regimen in patients with hypertension: A randomized clinical trial study. Iranian Journal of Nursing and Midwifery Research, 22(6), 427-430. doi: 10.4103/ijnmr
  7. Hibbard, J., & Gilburt, H. (2014). Supporting people to manage their health: An introduction to patient activation. London: The King’s Fund
  8. Husain, F., Johan, A., & Kusuma, H. (2019). Peningkatan manajemen diri pasien penyakit ginjal tahap akhir yang menjalani hemodialisis: Literature review. [Improvement of sel-management in patients with end terminal of renal failure getting hemodialysis]. In Prosiding Seminar Nasional Kolaborasi Pendidikan dan Pelayanan Keperawatan dalam Era Revolusi Industri 4.0. Semarang: Faculty of Medicine, Universitas Diponegoro
  9. Husain, F., Kusuma, H., & Johan, A. (2018). Peer support program in hemodialysis patients: An analytical literature review. In Proceeding of 2nd International Conference of Translational Medicine and Health Sciences in conjunction with 4th Java International Nursing Conference 2018. Semarang: Faculty of Medicine, Diponegoro University
  10. Indonesian Renal Registry. (2018). 11th Report of indonesian renal registry 2018. Retrieved from https://www.indonesianrenalregistry.org/data/IRR 2018.pdf
  11. Irajpour, A., Hashemi, M. S., Abazari, P., Shahidi, S., & Fayazi, M. (2018). The effects of peer support on depression, anxiety, and stress among patients receiving hemodialysis. Iranian Red Crescent Medical Journal, 20(S1):e66321. doi: 10.5812/ircmj.66321
  12. Kusuma, H., Ropyanto, C. B., Widyaningsih, S., & Sujianto, U. (2018). Relating factors of insomnia among hemodialysis patients. Nurse Media Journal of Nursing, 8(1), 44-57. doi: 10.14710/nmjn.v8i1.15741
  13. Li, H., Jiang, Y., & Lin, C. C. (2014). Factors associated with self-management by people undergoing hemodialysis: A descriptive study. International Journal of Nursing Studies, 51(2), 208–216. doi: 10.1016/j.ijnurstu.2013.05.012
  14. Lin, M. Y., Liu, M. F., Hsu, L. F., & Tsai, P. S. (2017). Effects of self-management on chronic kidney disease: A meta-analysis. International Journal of Nursing Studies, 74, 128-137. doi: 10.1016/j.ijnurstu.2017.06.008
  15. Magalhaes, L. P., Dos Reis, L. M., Graciolli, F. G., Pereira, B. J., De Oliveira, R. B., De Souza, A. A. L., … & Jorgetti, V. (2017). Predictive factors of one-year mortality in a cohort of patients undergoing urgent-start hemodialysis. PLoS ONE, 12(1), 1-13. doi: 10.1371/journal.pone.0167895
  16. Mahjubian, A., Bahraminejad, N., & Kamali, K. (2018). The effects of group discussion based education on the promotion of self-management behaviors in hemodialysis patients. Journal of Caring Sciences, 7(4), 225-232. doi: 10.15171/jcs.2018.034
  17. Malek-Khahi, A., Milani, M. J., & Amiri, P. (2015). The effects of peer support groups on mental health of hemodialysis patients. Iran Journal of Nursing, 28(96), 40-49. doi: 10.29252/ijn.28.96.40
  18. Ministry of Health Republic of Indonesia (MoHRI). (2019). Laporan hasil riset kesehatan dasar (Riskesdas) Indonesia tahun 2018 [Report on the 2018 Indonesia's basic health research]. Retrieved from https://www.kemkes.go.id/resources/ download/info-terkini/hasil-riskesdas-2018.pdf
  19. National Kidney Foundation. (2009). Benefits of peer support in people with chronic kidney disease. Retrieved from https://www.kidney.org/sites/default/files/docs/02-10-4196_ebb_benefitsprofessionalflyer.pdf
  20. Pamungkas, R. A., Chinnawong, T., & Kritpracha, C. (2015). The effect of dietary and exercise self-management support program on dietary behavior exercise behavior and clinical outcomes in muslim patients with poorly controlled type 2 DM in a community setting in Indonesia. Nurse Media Journal of Nursing, 5(1), 1-14. doi: 10.14710/nmjn.v5i1.10186
  21. Rijken, M., Jones, M., Dixon, M., & Anna, H. (2008). Supporting self-management. In E. Nolte & M. McKee (Eds.). Caring for people with chronic condition: A health system perspective. England: McGraw-Hill Education
  22. Robinson, B. M., Zhang, J., Morgenstern, H., Bradbury, B. D., Ng, L. J., Mccullough, K. P., … & Pisoni, R. L. (2014). Worldwide mortality risk is high soon after initiation of hemodialysis. Kidney International, 85, 158-165. doi: 10.1038/ki.2013.252
  23. Russell, J. S. C., Southerland, S., Huff, E. D., Thomson, M., Meyer, K. B., & Lynch, J. R. (2017). A peer-to-peer mentoring program for in-center hemodialysis: A patient-centered quality improvement program. Nephrology Nursing Journal, 44(6), 481-496
  24. Ryan, P. (2009). Integrated theory of health behavior change background and intervention. Clinical Nurse Specialist, 23(3), 161-170. doi: 10.1097/NUR.0b013e3181a42373
  25. Ryan, P., & Sawin, K. (2009). The individual and family self-management theory: background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225. doi: 10.1016/j.outlook.2008.10.004
  26. Saran, R., Robinson, B., Abbott, K. C., Bragg-Gresham, J., Chen, X., Gipson, D., ..., & Shahinian, V. (2019). US renal data system 2019 annual data report: Epidemiology of kidney disease in the United States. American Journal of Kidney Disease, 75(1 Suppl 1), A6-A7. doi: 10.1053/j.ajkd.2019.09.003
  27. Side by Side Research Consortium. (2017). Developing peer support in the community: A toolkit. London: Mind
  28. Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia: Lippincott Williams & Wilkins
  29. Taylor, F., Gutteridge, R., & Willis, C. (2016). Peer support for CKD patients and carers: Overcoming barriers and facilitating access. Health Expectations, 19(3), 617-630. doi: 10.1111/hex.12348
  30. Wang, C.-M., Qu, H.-Y., & Xu, H.-M. (2015). Relationship between social support and self-efficacy in women psychiatrists. Chinese Nursing Research, 2(4), 103-106. doi: 10.1016/j.cnre.2015.10.002
  31. Wang, H., Naghavi, M., Allen, C., Barber, R. M., Carter, A., Casey, D. C., …, & Zuhlke, L. J. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1459-1544. doi: 10.1016/S0140-6736(16)31012-1
  32. Williams, D. M., & Rhodes, R. E. (2016). The confounded self-efficacy construct: Conceptual analysis and recommendations for future research. Health Psychology Review, 10(2), 113-128. doi: 10.1080/17437199.2014.941998
  33. Yao, J., Wang, H., Yin, X., Yin, J., Guo, X., & Sun, Q. (2019). The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLOS ONE, 14(11), e0224869
  34. Yin, J., Wong, R., Au, S., Chung, H., Lau, M., Lin, L., …, & Chan, J. C. N. (2015). Effects of providing peer support on diabetes management in people with type 2 diabetes. Annals of Family Medicine, 13 Suppl 1(Suppl 1), S42-S49. doi: 10.1370/afm.1853

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