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慢性肾脏病患者在知识、自我管理和信心方面的激活。

Patient activation with knowledge, self-management and confidence in chronic kidney disease.

作者信息

Johnson Michelle L, Zimmerman Lani, Welch Janet L, Hertzog Melody, Pozehl Bunny, Plumb Troy

机构信息

Bryan College of Health Sciences, Lincoln, Nebraska, USA.

University of Nebraska Medical Center, Lincoln, Nebraska, USA.

出版信息

J Ren Care. 2016 Mar;42(1):15-22. doi: 10.1111/jorc.12142. Epub 2015 Nov 5.

Abstract

BACKGROUND

Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease.

OBJECTIVES

This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease.

DESIGN

The study employed a descriptive correlational design.

SETTINGS

Participants were recruited from five primary care, three nephrology clinics and one dialysis centre in two Midwestern cities in the United States.

PARTICIPANTS

The convenience sample included 85 adults with hypertension, diabetes mellitus and chronic kidney disease, including kidney failure, who spoke English.

MEASUREMENTS

Seven measurements were used to collect data via telephone interviews with participants not receiving haemodialysis, and face-to-face interviews with those receiving haemodialysis at the beginning of their treatment session.

RESULTS

Analyses indicated that half the participants were female (50.58%), the mean age was 63.21 years (SD = 13.11), and participants with chronic kidney disease stage 3 were the most activated. Post hoc differences were significant in patient activation and blood pressure self-management and anxiety across chronic kidney disease stages, excluding stage 5.

CONCLUSION

Engaging patients in the self-management of their health care and enhancing patients' ability to self-manage their blood pressure may work to preserve kidney health. Healthcare providers should collaborate with patients to develop strategies that will maintain patients' health-related quality of life, like reducing anxiety as kidney disease progress.

摘要

背景

慢性肾脏病是一个在全球范围内日益严重的健康问题。慢性肾脏病患病率的不断上升迫切需要更好地了解患者在疾病自我管理方面的知识、信心和参与度。

目的

本研究调查了慢性肾脏病五个阶段患者在患者激活度、健康相关生活质量、疾病知识、自我管理及慢性病管理信心方面的组间差异。

设计

本研究采用描述性相关设计。

地点

参与者招募自美国中西部两个城市的五家初级保健机构、三家肾脏病诊所和一家透析中心。

参与者

便利样本包括85名患有高血压、糖尿病和慢性肾脏病(包括肾衰竭)且说英语的成年人。

测量

通过电话访谈未接受血液透析的参与者,并在接受血液透析的参与者治疗开始时进行面对面访谈,使用七种测量方法收集数据。

结果

分析表明,一半的参与者为女性(50.58%),平均年龄为63.21岁(标准差=13.11),慢性肾脏病3期的参与者激活度最高。在慢性肾脏病各阶段(不包括5期),患者激活度、血压自我管理及焦虑方面的事后差异具有显著性。

结论

让患者参与医疗保健的自我管理并提高患者自我管理血压的能力可能有助于保护肾脏健康。医疗保健提供者应与患者合作制定策略,以维持患者与健康相关的生活质量,如在肾病进展时减轻焦虑。

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