Curtin Roberta Braun, Walters Brian A J, Schatell Dorian, Pennell Philip, Wise Meg, Klicko Kristi
Medical Education Institute Inc., Madison, WI 53719, USA.
Adv Chronic Kidney Dis. 2008 Apr;15(2):191-205. doi: 10.1053/j.ackd.2008.01.006.
Although past research has examined self-management among patients with end-stage renal disease (ESRD), little is known about self-management in patients with chronic kidney disease (CKD). In this cross-sectional survey (no intervention), 174 patients with CKD (serum creatinine > or =1.7 mg/dL) completed self-reported measures of self-efficacy, physical and mental functioning, and self-management. The purpose of the study was to explore the association between patients' perceived self-efficacy and their self-management behaviors. Five types of self-management behaviors were measured: communication with caregivers, partnership in care, self-care, self-advocacy, and medication adherence. Controlling for other relevant variables including age, education, diabetic status, hypertension, serum creatinine, physical functioning, and mental health functioning, higher perceived self-efficacy scores were associated with increased communication, partnership, self-care, and medication-adherence behaviors. In this study, patients' perceived self-efficacy was a more consistent correlate of self-management behavior than were demographic or health characteristics. Because self-management has been associated with positive patient outcomes, fostering self-management by supporting patient self-efficacy may have long-term benefits.
尽管过去的研究已经考察了终末期肾病（ESRD）患者的自我管理情况，但对于慢性肾病（CKD）患者的自我管理却知之甚少。在这项横断面调查（无干预）中，174例慢性肾病患者（血清肌酐≥1.7mg/dL）完成了关于自我效能感、身体和心理功能以及自我管理的自我报告测量。本研究的目的是探讨患者感知到的自我效能感与他们的自我管理行为之间的关联。测量了五种自我管理行为：与护理人员的沟通、护理中的伙伴关系、自我护理、自我维权以及药物依从性。在控制了包括年龄、教育程度、糖尿病状态、高血压、血清肌酐、身体功能和心理健康功能等其他相关变量后，较高的自我效能感得分与沟通、伙伴关系、自我护理和药物依从行为的增加相关。在本研究中，患者感知到的自我效能感比人口统计学或健康特征更一致地与自我管理行为相关。由于自我管理与患者的积极预后相关，通过支持患者的自我效能感来促进自我管理可能具有长期益处。
