Factors Influencing Self-Efficacy and Self-Management among Patients with Pre-End-Stage Renal Disease (Pre-ESRD)

• Published in: Healthcare (Basel) Vol. 9; no. 3; p. 266
• Main Authors: Lai, Pao-Chin, Wu, Shu-Fang Vivienne, Alizargar, Javad, Pranata, Satriya, Tsai, Juin-Ming, Hsieh, Nan-Chen
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.03.2021; MDPI
• Subjects: Activities of daily living; Anxiety; Chinese languages; chronic kidney disease patients; Correlation analysis; Data analysis; depression; end-stage renal disease (ESRD); Generalized linear models; Hemodialysis; Hospitals; Kidney diseases; Lifestyles; Medical records; Mental depression; Mortality; Nephrology; Patients; Quality of life; Questionnaires; Self-efficacy; self-management; Taiwan; anxiety; depression; chronic kidney disease patients; self-management; end-stage renal disease (ESRD); self-efficacy
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare9030266

Chronic kidney disease (CKD) is an emerging major public health issue that leads to end-stage kidney disease (ESRD). Factors influencing the self-management and self-efficacy of ESRD patients are still under investigation. The objective of this study is to evaluate the association of depression and anxiety with self-management and self-efficacy in patients with pre-ESRD. Patients in the department of nephrology of a regional hospital in Taiwan were invited to participate and were included in our study if they had a confirmed diagnosis of early-stage CKD, were more than 20 years old, and could converse in Mandarin Chinese or Taiwanese. Patients diagnosed with depression, who could not execute self-care, or who had cognitive deficits were excluded. In total, this cross-sectional study included 112 pre-ESRD patients. We used the Chinese versions of the hospital anxiety and depression scale (HADS), the chronic kidney disease self-efficacy instrument (CKD-SE), and the chronic kidney disease self-management instrument (CKD-SM) as the questionnaire. Spearman's rank correlation and logistic regressions were used to analyze the data. The top quartile of self-management and self-efficacy scores (28 patients) was defined as high self-management and -efficacy, respectively, and the lower three quartiles as low self-management and -efficacy. The logistic regression analysis showed that having depression decreased the odds of having high self-management by 75.4% and high self-efficacy by 75.1%. Having an education level of senior high school or above increased the odds ratios for having high self-management and high self-efficacy to 4.47 and 3.56 (all p-values < 0.05). Controlling depression as well as increasing the level of education can potentially increase self-management and self-efficacy in pre-ESRD patients.