skip to main content

Self-Management and Relating Factors among Chronic Kidney Disease Patients on Hemodialysis: An Indonesian Study

*Fitri Mailani orcid scopus  -  Faculty Of Nursing, Universitas Andalas, Indonesia
Emil Huriani  -  Faculty of Nursing, Universitas Andalas, Indonesia
Rahmi Muthia  -  Faculty of Nursing, Universitas Andalas, Indonesia
Rahmiwati Rahmiwati  -  Dr. M. .Jamil Padang Hospital, Indonesia
Open Access Copyright (c) 2023 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: The latest approach to managing chronic kidney disease (CKD) involves the implementation of self-management methods. Nonetheless, numerous previous studies indicate that self-management behaviors remain inadequate among hemodialysis patients in Indonesia. Therefore, a deeper comprehension of the factors that affect a patient’s self-management should be studied.

Purpose: This study aimed to examine self-management among CKD patients undergoing hemodialysis and its relating factors.

Methods: The study used a cross-sectional approach. A convenience sample of 164 patients undergoing hemodialysis determined using a table of power analysis was recruited from two hemodialysis centers in Padang, Indonesia, from May to July 2022. Hemodialysis self-management instrument-18 (HDSMI-18), the scale of self-efficacy for chronic diseases, and the hemodialysis knowledge questionnaire were used as the instruments. T-tests, ANOVA, Spearman correlation test, and multiple linear regression were used to analyse the data.

Results: Self-management, knowledge, and self-efficacy mean scores were 48.62(8.45), 17.77(2.96), and 43.05(10.08), respectively. There was a significant positive correlation between self-management with education (p=0.000), employment status (p=0.025), monthly income (p=0.003), knowledge (p=0.000), and self-efficacy (p=0.004). Multiple linear regression analyses for overall self-management indicated that knowledge and education were the main influencing factors of self-management.

Conclusion: Hemodialysis patients had a subpar degree of self-management. Furthermore, knowledge and education were the most significant influencing factors of self-management. Nurses are expected to be able to provide structured education to increase patient knowledge which will later yield good self-management.
Fulltext View|Download
Keywords: Chronic kidney disease; hemodialysis; knowledge; self-efficacy; self-management

Article Metrics:

  1. Almutary, H., & Tayyib, N. (2021). Evaluating self-efficacy among patients undergoing dialysis therapy. Nursing Reports, 11(1), 195-201. https://doi.org/10.3390/nursrep11010019
  2. Ameh, O. I., Udeme E. E., & Andre P. K. (2020). Preventing CKD in low- and middle-income countries: A call for urgent action. Kidney International Reports, 5(3), 255–62. https://doi.org/10.1016/j.ekir.2019.12.013
  3. Chen, Y. C., Chang, L. C., Liu, C. Y., Ho, Y. F., Weng, S. C., & Tsai, T. I. (2018). The roles of social support and health literacy in self‐management among patients with chronic kidney disease. Journal of Nursing Scholarship, 50(3), 265-275. https://doi.org/10.1111/jnu.12377
  4. Chen, W. C., Lin, C. C., Wu, C. C., & Song, Y. C. (2021). Psychometric testing of the hemodialysis self‐management instrument (HDSMI‐18): A confirmatory factor analysis. Nursing Open, 8(5), 2832-2839. https://doi.org/10.1002/nop2.867
  5. Cho, M. K., & Shin, G. (2016). Gender-based experiences on the survival of chronic renal failure patients under hemodialysis for more than 20 years. Applied Nursing Research, 32, 262– 268. https://doi.org/10.1016/j.apnr.2016.08.008
  6. Curtin, R. B., Bultman Sitter, D. C., Schatell, D., & Chewning, B. A. (2004). Self-management, knowledge, and functioning and well-being of patients on hemodialysis. Nephrology Nursing Journal, 31(4), 378-387
  7. Denhaerynck, K., Manhaeve, D., Dobbels, F., Garzoni, D., Nolte, C., & De Geest, S. (2007). Prevalence and consequences of nonadherence to hemodialysis regimens. American Journal of Critical Care, 16(3), 222-235. https://doi.org/10.4037/ajcc2007.16.3.222
  8. de Quiros, F. G. B., Dawidowski, A. R., & Figar, S. (2017). Representation of people’s decisions in health information systems. Methods of Information in Medicine, 56(S 01), e13-e19. https://doi.org/10.3414/ME16-05- 0001
  9. Devraj, R., Borrego, M. E., Vilay, A. M., Pailden, J., & Horowitz, B. (2018). Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice. World Journal of Nephrology, 7(1), 41–50. https://doi.org/10.5527/wjn.v7.i1.41
  10. Griva, K., Mooppil, N., Seet, P., Krishnan, D. S. P., James, H., & Newman, S. P. (2011). The NKF-NUS hemodialysis trial protocol-A randomized controlled trial to determine the effectiveness of a self management intervention for hemodialysis patients. BMC Nephrology, 12(1), 1-11. https://doi.org/10.1186/1471-2369-12-4
  11. Hafezieh, A., Dehghan, M., Taebi, M., & Iranmanesh, S. (2020). Self-management, self-efficacy and knowledge among patients under haemodialysis: A case in Iran. Journal of Research in Nursing, 25(2), 128-138. https://doi.org/10.1177/1744987120904770
  12. Huong, V. T. T., & Le, N. T. (2015). New practical approachs to estimation of glomerular filtration rate in adult: A review. In: Paper Presented at the 5th International Conference on Biomedical Engineering in Vietnam, 46, 78–80. https://doi.org/10.1007/978-3- 319- 11776 -8_ 66
  13. Husain, F., Kusuma, H., & Johan, A. (2020). Effects of peer support program on self-management in patients with end-stage renal disease undergoing hemodialysis. Nurse Media Journal of Nursing, 10(2), 171–181. https://doi.org/10.14710/nmjn.v10i2.26502
  14. Indonesian Renal Registry. (2018). 11th report of Indonesian renal registry 2018. https://www.indonesianrenalregistry.org/data/IRR 2018.pdf. 2018
  15. Li, H., Jiang, Y. F., & 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. https://doi.org/10.1016/j.ijnurstu.2013.05.012
  16. Lin, C. C., Tsai, F. M., Lin, H. S., Hwang, S. J., & Chen, H. C. (2013). Effects of a self-management program on patients with early-stage chronic kidney disease: A pilot study. Applied Nursing Research, 26(3), 151-156. htpps://doi.org/10.1016/j.apnr.2013.01.002
  17. Lorig, K. R., & Holman, H. R. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7. https://doi.org/10.1207/S15324796ABM2601_01
  18. Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Jr, Bandura, A., Ritter, P., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care, 37(1), 5-14. https://doi.org/10.1097/00005650-199901000-00003
  19. Luyckx, V. A., Tonelli, M., & Stanifer, J. W. (2018). The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization, 96(6), 414-22. https://doi.org/10.2471/BLT.17.206441
  20. Mailani, F., Herien, Y., Muthia, R., Tumanggor, R. D., & Huriani, E. (2022). The experiences of patients with chronic kidney disease undergoing dialysis in managing the symptoms. Malaysian Journal of Medicine and Health Sciences, 18(SUPP18): 42-50
  21. Mailani , F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021). The fluid management experience in patients with chronic kidney disease undergoing hemodialysis in Indonesia: A qualitative study. Nurse Media Journal of Nursing, 11(3), 389-403. https://doi.org/10.14710/nmjn.v11i3.38838
  22. Malini, H., Zhahara, S., Lenggogeni, D. P., & Putri, Z. M. (2022). Self-care and quality of life people with type 2 diabetes during the covid-19: Cross-sectional study. Journal of Diabetes & Metabolic Disorders, 21(1), 785-790. https://doi.org/10.1007/s40200-022-01055-7
  23. Moattari, M., Ebrahimi, M., Sharifi, N., & Rouzbeh, J. (2012). The effect of empowerment on the self-efficacy, quality of life and clinical and laboratory indicators of patients treated with hemodialysis: A randomized controlled trial. Health and Quality of Life Outcomes, 10, 1-10. https://doi.org/10.1186/1477-7525-10-115
  24. Mousa, I., Ataba, R., Al-ali, K., Alkaiyat, A., & Zyoud, S. E. H. (2018). Dialysis-related factors affecting self-efficacy and quality of life in patients on haemodialysis: A cross-sectional study from Palestine. Renal Replacement Therapy, 4(1), 1-12. https://doi.org/10.1186/s41100-018-0162-y
  25. Natashia, D., Yen, M., Chen, H. M., & Fetzer, S. J. (2019). Self‐management behaviors in relation to psychological factors and interdialytic weight gain among patients undergoing hemodialysis in Indonesia. Journal of Nursing Scholarship, 51(4), 417-426. https://doi.org/10.1111/jnu.12464
  26. Polit, D. F., & Beck, C. T. (2008). Nursing: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins
  27. Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and social cognitive theory. Contemporary Educational Psychology, 60, 1011832. https://doi.org/10.1016/j.cedps ych.2019.101832
  28. Smith, K., Coston, M., Glock, K., Elasy, T.A., Wallston, K.A., Ikizler, T. A., and K. L. Cavanaugh. (2010). Patient perspectives on fluid management in chronic hemodialysis. Journal of Renal Nutrition, 20(5), 334–341. https://doi.org/10.1053/j.jrn.2009.09.001
  29. Stevenson, J., Tong, A., Gutman, T., Campbell, K. L., Craig, J. C., Brown, M. A., & Vincent, W. (2018). Experiences and perspectives of dietary management among patients on hemodialysis: An interview study. Journal of Renal Nutrition, 28(6), 411-421. https://doi.org/10.1053/j.jrn.2018.02.005
  30. Suarilah, I., & Lin, C. C. (2022). Factors influencing self‐management among Indonesian patients with early‐stage chronic kidney disease: A cross‐sectional study. Journal of Clinical Nursing, 31(5-6), 703-715. https://doi.org/10.1111/jocn.15930
  31. Thomas, N. (2019). Renal nursing: Care and management of people with kidney disease. John Wiley & Sons
  32. Van Prooijen, J. W. (2017). Why education predicts decreased belief in conspiracy theories. Applied Cognitive Psychology, 31(1), 50–58. https://doi.org/10.1002/acp.3301
  33. Wang, A., & MA, J. (2005). Self-management behavior and health-related quality of life in Chinese hemodialysis patients. Chinese Journal of Tissue Engineering Research, 192-194
  34. Wu, S. F. V., Hsieh, N. C., Lin, L. J., & Tsai, J. M. (2016). Prediction of self‐care behaviour on the basis of knowledge about chronic kidney disease using self‐efficacy as a mediator. Journal of clinical nursing, 25(17-18), 2609-2618. https://doi.org/10.1111/jocn.13305
  35. Yusuf, A. H., Suarilah, I., & Rahmat, P. (2017). Relaxation affirmation technique increases self-efficacy of patients with nasopharingeal cancer. Jurnal Ners, 5(1), 29–37. http://dx.doi.org/10.20473/ jn.v5i1.3921

Last update:

  1. Correlation of the caring behaviour of nurses with the motivation of patients undergoing haemodialysis

    Pohan Yosafianti, Arief Yanto, Satriya Pranata. Scripta Medica, 55 (2), 2024. doi: 10.5937/scriptamed55-48753

Last update: 2024-12-05 14:32:54

No citation recorded.