Cui Yi, Liu Na, Guo Zhihua, Liu Qin, Zhang Man, Li Jiayao, Mu Hezi, Zhang Yinling, Chen Xia
Department of Nursing, Air Force Medical University, Xi'an, People's Republic of China.
Department of Military Medical Psychology, Air Force Medical University, Xi'an, People's Republic of China.
Patient Prefer Adherence. 2025 Jan 22;19:161-172. doi: 10.2147/PPA.S494483. eCollection 2025.
Effective self-management in the early stage of chronic kidney disease (CKD) is key to delaying disease progression. However, no studies have confirmed that the combined support of internal individual factors and external family environmental factors may play an important role in the self-management of patients with early CKD.
This current study aims to explore the effect of family function on the self-management of patients with early CKD and examine the mediating roles of self-perceived burden and ego depletion.
Three hundred and sixty patients with stage 1-3 CKD participated in the cross-sectional survey and completed structured questionnaires, including the family APGAR index, self-perceived burden scale, self-regulatory fatigue scale and chronic kidney disease self-management instrument. Mplus 8.3 was used to establish a structural equation model.
Family function had a positive predictive effect on self-management ( = 0.231, < 0.001). Self-perceived burden and ego depletion were not only single mediating variables between family function and self-management but also played a chain-mediating role. The total indirect effect was 0.304 (95% CI: 0.234 to 0.388, < 0.001), accounting for 56.82% of the total effect ( = 0.535, 95% CI: 0.420 to 0.651, < 0.001).
This study highlights the importance of self-management for patients and their families and provides new important theoretical guidance for multiple interventions of improving family function, reducing self-perceived burden and ego depletion to improve self-management, which is of great value in delaying the progression of renal disease.
慢性肾脏病（CKD）早期有效的自我管理是延缓疾病进展的关键。然而，尚无研究证实内部个体因素和外部家庭环境因素的联合支持可能在CKD早期患者的自我管理中发挥重要作用。
本研究旨在探讨家庭功能对CKD早期患者自我管理的影响，并检验自我感知负担和自我损耗的中介作用。
360例1-3期CKD患者参与了横断面调查，并完成了结构化问卷，包括家庭APGAR指数、自我感知负担量表、自我调节疲劳量表和慢性肾脏病自我管理工具。使用Mplus 8.3建立结构方程模型。
家庭功能对自我管理具有正向预测作用（β = 0.231，P < 0.001）。自我感知负担和自我损耗不仅是家庭功能与自我管理之间的单一中介变量，还发挥了链式中介作用。总间接效应为0.304（95%CI：0.234至0.388，P < 0.001），占总效应的56.82%（β = 0.535，95%CI：0.420至0.651，P < 0.001）。
本研究强调了自我管理对患者及其家庭的重要性，并为改善家庭功能、减轻自我感知负担和自我损耗以提高自我管理的多重干预提供了新的重要理论指导，这对延缓肾脏疾病进展具有重要价值。
