题名

Predictors of Self-Management Behaviors After Discharge Among Unplanned Dialysis Patients

DOI

10.1097/jnr.0000000000000523

作者

Yu-Yin KAO;Chien-Te LEE;Ruey-Hsia WANG

关键词

unplanned dialysis ; uncertainty in illness ; self-care knowledge ; social support ; self-management behaviors

期刊名称

The Journal of Nursing Research

卷期/出版年月

31卷2期(2023 / 04 / 01)

页次

1 - 8

内容语文

英文

中文摘要

Background: Patients with unplanned dialysis must perform self-management behaviors to maintain their health in the community after discharge. Understanding the factors that predict the postdischarge self-management behaviors of patients with unplanned dialysis can assist nurses to implement appropriate discharge plans for this population. Purpose: This study was designed to predict the effects of uncertainty in illness, self-care knowledge, and social-support-related needs during hospitalization on the self-management behaviors of patients with unplanned dialysis during their first 3 months after discharge from the hospital. Methods: One hundred sixty-nine patients with unplanned dialysis from the nephrology department of a medical center in Taiwan were enrolled in this prospective study using convenience sampling. At hospital admission, demographic, uncertainty in illness, self-care knowledge, and social support information was collected using a structured questionnaire. Information on self-management behavior was collected at 3 months postdischarge when the patients visited outpatient clinics. Results: Hierarchical multiple regression analyses showed that self-care knowledge, uncertainty in illness, and social support were important predictors of self-management behaviors at 3 months postdischarge, explaining 65.6% of the total variance in self-management behaviors. Social support increased the variance in self-management behaviors by 27.9%. Conclusions/Implications for Practice: Comprehensive discharge planning to improve the postdischarge self-management behaviors of patients with unplanned dialysis should involve interventions to improve self-care knowledge, reduce uncertainty in illness, and increase social support. Building social support should be given priority attention.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Chen, P.-C.,Lu, K.-C.,Lee, P.-H.,Miao, N.-F.(2020).Factors associated with social support, self-care behavior, and the quality of life among hemodialysis patients.New Taipei Journal of Nursing,22(1),33-46.
    連結:
  2. Barrera, J. M.(1986).Distinctions between social support concepts, measures, and models.American Journal of Community Psychology,14(4),413-445.
  3. Bikbov, B.,Purcell, C. A.,Levey, A. S.,Smith, M.,Abdoli, A.,Abebe, M.,Vos, T.(2020).Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017.The Lancet,395(10225),709-733.
  4. Chia, J. M. X.,Goh, Z. S.,Seow, P. S.,Seow, T. Y.,Choo, J. C. J.,Foo, M. W.,Newman, S.,Griva, K.(2021).Psychosocial factors, intentions to pursue arteriovenous dialysis access, and access outcomes: A cohort study.American Journal of Kidney Diseases,77(6),931-940.
  5. Cho, Y. M.,Seo, Y. H.,Park, M. J.(2018).Relationship between uncertainty in illness, subjective health status, and compliance with sick role behavior according to levels of health literacy in hemodialysis patients.Korean Journal of Adult Nursing,30(4),437-446.
  6. Cohen, J.(1988).Statistical power analysis for the behavioral sciences.Lawrence Erlbaum Associates.
  7. El-Etreby, R. R.,El-Monshed, A. H. E.-S.(2019).Effect of self-management program on quality of life for patients with chronic kidney disease.American Journal of Nursing Research,7(4),657-663.
  8. Gela, D.,Mengistu, D.(2018).Self-management and associated factors among patients with end-stage renal disease undergoing hemodialysis at health facilities in Addis Ababa, Ethiopia.International Journal of Nephrology and Renovascular Disease,11,329-336.
  9. Golestaneh, L.(2018).Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift.Seminars in Dialysis,31(3),278-288.
  10. Griva, K.,Seow, P. S.,Seow, T. Y.,Goh, Z. S.,Choo, J. C. J.,Foo, M.,Newman, S.(2020).Patient-related barriers to timely dialysis access preparation: A qualitative study of the perspectives of patients, family members, and health care providers.Kidney Medicine,2(1),29-41.
  11. Jasinski, M. J.,Lumley, M. A.,Soman, S.,Yee, J.,Ketterer, M. W.(2018).Family consultation to reduce early hospital readmissions among patients with end stage kidney disease: A randomized controlled trial.Clinical Journal of the American Society of Nephrology,13(6),850-857.
  12. Kim, B.,Kim, J.(2019).Influence of uncertainty, depression, and social support on self-care compliance in hemodialysis patients.Therapeutics and Clinical Risk Management,15,1243-1251.
  13. Li, H.,Jiang, Y.-F.,Lin, C.-C.(2014).Factors associated with self-management by people undergoing hemodialysis: A descriptive study.International Journal of Nursing Studies,51(2),208-216.
  14. Lin, M. Y.,Liu, M. F.,Hsu, L. F.,Tsai, P. S.(2017).Effects of self-management on chronic kidney disease: A meta-analysis.International Journal of Nursing Studies,74,128-137.
  15. Llewellyn, S.(2017).Concept clarification: Uncertainty in individuals with chronic kidney disease.Nephrology Nursing Journal,44(6),513-539.
  16. Machowska, A.,Alscher, M. D.,Reddy Vanga, S.,Koch, M.,Aarup, M.,Qureshi, A. R.,Lindholm, B.,Rutherford, P. A.(2016).Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients.Patient Preference and Adherence,10,2229-2237.
  17. Mishel, M. H.(1988).Uncertainty in illness.Image: The Journal of Nursing Scholarship,20(4),225-232.
  18. Moist, L. M.,Lok, C. E.(2017).Incident dialysis access in patients with end-stage kidney disease: What needs to be improved.Seminars in Nephrology,37(2),151-158.
  19. Olaitan, A.,Ashman, N.,Homer, K.,Hull, S.(2019).Predictors of late presentation to renal dialysis: A cohort study of linked primary and secondary care records in East London.BMJ Open,9(6),e028431.
  20. Reyes, M.,Fuertes, J. N.,Moore, M. T.,Punnakudiyil, G. J.,Calvo, L.,Rubinstein, S.(2020).Psychological and relational factors in ESRD hemodialysis treatment in an underserved community.Patient Education and Counseling,104(1),149-154.
  21. Roy, D.,Chowdhury, A. R.,Pande, S.,Kam, J. W.(2017).Evaluation of unplanned dialysis as a predictor of mortality in elderly dialysis patients: A retrospective data analysis.BMC Nephrology,18(1),364.
  22. Schanz, M.,Ketteler, M.,Heck, M.,Dippon, J.,Alscher, M. D.,Kimmel, M.(2017).Impact of an in-hospital patient education program on choice of renal replacement modality in unplanned dialysis initiation.Kidney and Blood Pressure Research,42(5),865-876.
  23. Schrauben, S. J.,Cavanaugh, K. L.,Fagerlin, A.,Ikizler, T. A.,Ricardo, A. C.,Eneanya, N. D.,Nunes, J. W.(2020).The relationship of disease-specific knowledge and health literacy with the uptake of self-care behaviors in CKD.Kidney International Reports,5(1),48-57.
  24. Sheu, S.,Huang, S.-L.(1996)。Validation of Chinese version of Mishel's uncertainty in illness scale。The Journal of Nursing,4(1),59-68。
  25. Song, Y. C.,Lin, C. C.(2009)。The development and testing of a new hemodialysis self-management instrument (HD-SMI)。Journal of Nursing and Healthcare Research,5(1),51-59。
  26. Sousa, H.,Ribeiro, O.,Paúl, C.,Costa, E.,Miranda, V.,Ribeiro, F.,Figueiredo, D.(2019).Social support and treatment adherence in patients with end-stage renal disease: A systematic review.Seminars in Dialysis,32(6),562-574.
  27. Tu, Y. R.,Tsai, T. Y.,Lin, M. S.,Tu, K. H.,Lee, C. C.,Wu, V. C.,Hsu, H. H.,Chang, M. Y.,Tian, Y. C.,Chang, C. H.(2020).Association between initial dialytic modalities and the risks of mortality, infection death, and cardiovascular events: A nationwide population-based cohort study.Scientific Reports,10(1),1-8.
  28. Vandenberg, A. E.,Bowling, C. B.,Adisa, O.,Sahlie, A.,Nadel, L.,Lea, J.,Plantinga, L. C.(2019).Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions.Patient Education and Counseling,102(7),1280-1287.
  29. Wang, S. L.,Chiu, Y. W.,Kung, L. F.,Chen, T. H.,Hsiao, S. M.,Hsiao, P. N.,Hwang, S. J.,Hsieh, H. M.(2019).Patient assessment of chronic kidney disease self-care using the chronic kidney disease self-care scale in Taiwan.Nephrology,24(6),615-621.
  30. Wu, S. F.,Hsieh, N. C.,Lin, L. J.,Tsai, J. M.(2016).Prediction of self-care behaviour on the basis of knowledge about chronic kidney disease using self-efficacy as a mediator.Journal of Clinical Nursing,25(17-18),2609-2618.
  31. Xie, Y.,Bowe, B.,Mokdad, A. H.,Xian, H.,Yan, Y.,Li, T.,Maddukuri, G.,Tsai, C. Y.,Floyd, T.,Al-Aly, Z.(2018).Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016.Kidney International,94(3),567-581.
  32. Yu, D. S.,Lee, D. T.,Woo, J.(2004).Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C).Research in Nursing & Health,27(2),135-143.