Factors influencing self‐management among Indonesian patients with early‐stage chronic kidney disease: A cross‐sectional study

• Published in: Journal of clinical nursing Vol. 31; no. 5-6; pp. 703 - 715
• Main Authors: Suarilah, Ira, Lin, Chiu‐Chu
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2022
• Subjects: chronic kidney disease; Cross-Sectional Studies; Demographics; Disease management; Health behavior; Health education; Health Literacy; health risk; Health risks; Humans; illness perception; Illnesses; Indonesia; Kidney diseases; Patient compliance; Renal Insufficiency, Chronic - therapy; Self-Management; self‐efficacy; Indonesia; health risk; chronic kidney disease; health literacy; self-management; illness perception; self-efficacy
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.15930

Aims and objectives The purpose of this study was to explore the self‐management of patients with early‐stage chronic kidney disease (CKD) and its influencing factors. Methods A convenient sample of 226 patients with early‐stage CKD was recruited from 63 Public Health Centers in Indonesia, from June to September 2020. Demographic characteristics, health literacy, illness perception, self‐efficacy and self‐management were assessed using self‐reported questionnaires. Stepwise multiple linear regression analysis was performed to identify the factors influencing self‐management. This study adhered to the EQUATOR checklist, STROBE. Results The mean estimated glomerular filtration rate was 63.45 ml/min/1.73 m2 (standard deviation [SD] = 15.34). The average scores for health literacy, illness perception, self‐efficacy and self‐management were 32.11 (SD = 4.46), 4.57 (SD = 1.46), 183.64 (SD = 38.23) and 76.92 (SD = 9.45), respectively. The influencing factors were education level, monthly income, family history of comorbidity, health literacy and self‐efficacy, which accounted for 45% of total self‐management score. Conclusions Indonesian patients with early‐stage CKD showed low level of health literacy, but positive illness perception and self‐efficacy; these factors significantly affected CKD self‐management. Health literacy was found to influence all dimensions of self‐management: self‐integration, problem‐solving, seeking social support and adherence to the recommended regimen. Relevance to clinical practice Adherence to the recommended regimen is the most challenging dimension of CKD self‐management. Health literacy was found to be a major determinant of self‐management. Improving health literacy and motivation of patients with early‐stage CKD may help sustain positive illness perception and self‐efficacy, and improve self‐management.