The effects of knowledge and self‐management of patients with early‐stage chronic kidney disease: Self‐efficacy is a mediator

Abstract

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.

Factors Influencing Self-Management among Non-Dialysis Chronic Kidney Disease Patients

“…To date, evidence on self-management for patients with earlier stages of kidney disease is still insufficient. To improve active self-management behaviors and facilitate decisionmaking for non-dialysis CKD patients at different stages (3)(4)(5), specific knowledge related to kidney disease should be assessed and improved. This is the first Saudi Arabian study to highlight such a topic with significant results.…”

“…With disease progression, people with CKD often experience multiple symptoms and develop cardiovascular complications and other comorbidities, which require continuous monitoring and care [ 4 ]. Caring for these patients involves preservation of physical and psychological functioning, delaying disease progression, and preventing potential complications [ 5 ]. An extensive body of literature suggests that a part of the caring responsibility should be conducted by patients as self-management [ 6 , 7 ].…”

“…In addition, there is some evidence showing that patients with stage 1–5 CKD who received self-management programs have lower hospitalization rates [ 10 ] and better medication adherence than others on routine care [ 11 ]. A recent study has shown that there is a strong relationship between self-management and knowledge in the early stages of CKD [ 5 ]. Gaining sufficient knowledge could enhance self-management behavior.…”

“…Limited data are available worldwide regarding knowledge and self-management among non-dialysis CKD patients. Several studies have shown that knowledge levels among non-dialysis patients are low to moderate [ 5 , 22 , 23 ], whereas others have shown a low level of self-management among patients with CKD [ 5 , 24 , 25 ]. Of these, studies addressing the correlation between these two concepts are limited.…”

“…Of these, studies addressing the correlation between these two concepts are limited. Chuang et al (2020) showed that disease knowledge and self-management are strongly associated with the early stages of CKD [ 5 ]. Moreover, findings from a qualitative study showed that there is a window for improving CKD self-management by enhancing knowledge [ 26 ].…”