Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.
Health Expect. 2021 Jun;24(3):843-852. doi: 10.1111/hex.13225. Epub 2021 Apr 9.
Patient activation describes the knowledge, skills and confidence in managing one's own health. Promoting patient activation is being prioritized to reduce costs and adverse outcomes such as cardiovascular disease (CVD). The increasing prevalence of chronic kidney disease (CKD) presents a need to understand the characteristics that influence patient activation and the effect on health outcomes.
Cross-sectional study.
Patients with non-dialysis CKD recruited from 14 sites (general nephrology and primary care) in England, UK.
Patient activation was measured using the PAM-13. Demographic and health-related variables, self-reported symptom burden, health-related quality of life (HRQOL), socioeconomic status (SES), were assessed as determinants of patient activation. Major CVD risk factors included hypertension, dyslipidaemia, obesity and hyperkalaemia.
743 patients were included (eGFR: 32.3 ( 17.1) mL/min/1.73 m , age 67.8 ( 13.9) years, 68% male). The mean PAM score was 55.1 ( 14.4)/100. Most patients (60%) had low activation. Those with low activation were older (P<.001), had lower eGFR (P = .004), greater number of comorbidities (P = .026) and lower haemoglobin (P = .025). Patients with low activation had a 17% greater number of CVD risk factors (P < .001). Risk factors in those with low activation were being older (P < .001) and having diabetes (P < .001).
This study showed that only a minority of CKD patients are activated for self-management. Our findings help better understand the level of activation in these patients, particularly older individuals with multimorbidity, and further the knowledge regarding the characteristics that influence activation.
Patients were involved in the design of main study.
患者激活描述了患者管理自身健康的知识、技能和信心。优先促进患者激活，以降低成本和心血管疾病（CVD）等不良后果。慢性肾脏病（CKD）的患病率不断上升，需要了解影响患者激活的特征及其对健康结果的影响。
横断面研究。
在英国英格兰的 14 个地点（普通肾病和初级保健）招募了非透析性 CKD 患者。
使用 PAM-13 测量患者激活。人口统计学和与健康相关的变量、自我报告的症状负担、健康相关生活质量（HRQOL）、社会经济地位（SES）被评估为患者激活的决定因素。主要 CVD 危险因素包括高血压、血脂异常、肥胖和高钾血症。
共纳入 743 例患者（eGFR：32.3（17.1）mL/min/1.73m，年龄 67.8（13.9）岁，68%为男性）。平均 PAM 评分为 55.1（14.4）/100。大多数患者（60%）的激活程度较低。那些激活程度较低的患者年龄较大（P<.001），eGFR 较低（P=.004），合并症较多（P=.026），血红蛋白较低（P=.025）。低激活患者 CVD 危险因素增加 17%（P<.001）。低激活患者的危险因素为年龄较大（P<.001）和患有糖尿病（P<.001）。
本研究表明，只有少数 CKD 患者具有自我管理的激活能力。我们的研究结果有助于更好地了解这些患者的激活水平，特别是患有多种疾病的老年患者，并进一步了解影响激活的特征。
患者参与了主要研究的设计。
