Aim The purpose of this study is to investigate the relationship among knowledge, self‐efficacy, and self‐management of patients with early‐stage chronic kidney disease (ESCKD). Methods This is a cross‐sectional correlational study design. This study used purposive sampling to enroll a total of 130 patients with ESCKD. The research instruments included Chronic Kidney Disease Self‐Care Knowledge Scale, Chronic Kidney Disease Self‐Efficacy Instrument, Chronic Kidney Disease Self‐Management Scale, and so on. This study used the statistical software SPSS 20.0 to perform statistical analyses, such as descriptive statistical analysis, independent samples t test, one‐way analysis of variance, Pearson product–moment correlation coefficient analysis, and multiple hierarchical regression analysis. Results The knowledge of patients with early kidney disease was moderate (55.10%), self‐efficacy was moderate (54.44%), and self‐management was moderate (61.11%). The disease knowledge and self‐efficacy (r = .59, p < .01) were significantly positively correlated with self‐management (r = .50, p < .01); the intervening effect of self‐efficacy on self‐management (z = 4.58, p < .001) reached statistically significant difference. Self‐efficacy was the most significant predictor for self‐management and explained 49% of the total variance. Conclusions This study suggested that self‐efficacy was a mediator and predictor for self‐management. The research results may serve as reference for related administrative authorities or medical personnel to develop self‐efficacy strategies with theoretical basis, as well as appropriate self‐efficacy improvement schemes, to transform the methods for enhancing disease knowledge to improve the intervention with self‐efficacy language or method and increase patients' disease self‐management.

Aim: 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. Methods: 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. Results: 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). Conclusion: Controlling depression as well as increasing the level of education can potentially increase self-management and self-efficacy in pre-ESRD patients.

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