Research on self-management behavior and influencing factors among maintenance hemodialysis patients_West China Medical Journal

Authors：

ZHOU Yu ¹ , WANG Wenxiu ² , CAO Xiaoyi ³ ,  JIANG Xiaolian ¹

1. West China School of Nursing, Sichuan University / West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Respiratory and Intensive Care, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Center for Blood Purification, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

JIANG Xiaolian, Email: jiangxiaolianhl@163.com

Keywords：

Maintenance hemodialysis; Self-management behavior; Health locus of control; Hope; Chronic illness resource

DOI：

10.7507/1002-0179.202102028

Video：

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Objective To investigate the level and influencing factors of self-management behaviors among maintenance hemodialysis patients.Methods Patients undergoing maintenance hemodialysis were recruited from 4 tertiary hospitals in Chengdu from October 2016 to October 2017. Convenient sampling method was used to select patients. The instruments used in the study included General Information Questionnaire, Hemodialysis Self-management Instrument, Hemodialysis-related Knowledge Questionnaire, Herth Hope Index, Multidimensional Health Locus of Control Scale, and Chronic Illness Resources Survey.Results A total of 360 patients were investigated, and 343 patients were finally included. The mean score of self-management behavior was 54.87±9.65. The results of multiple linear stepwise regression showed that gender, age, ethnic, monthly family income, chronic illness resources, knowledge and internal health locus of control were the significant influencing factors of self-management behaviors (P<0.05).Conclusion The self-management behavior among patients undergoing maintenance hemodialysis can be promoted by improving the level of knowledge and internal health locus of control, and making effective use of chronic illness resources.

Citation： ZHOU Yu, WANG Wenxiu, CAO Xiaoyi, JIANG Xiaolian. Research on self-management behavior and influencing factors among maintenance hemodialysis patients. West China Medical Journal, 2021, 36(8): 1077-1082. doi: 10.7507/1002-0179.202102028 Copy

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3.	Lin MY, Liu MF, Hsu LF, et al. Effects of self-management on chronic kidney disease: a meta-analysis. Int J Nurs Stud, 2017, 74: 128-137.
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13.	程彦伶, 刘敏, 王丽丽, 等. 维持性血液透析患者自我管理行为、生活质量现状调查及相关性研究. 齐鲁护理杂志, 2020, 26(24): 37-40.
14.	Al-Shammari N, Al-Modahka A, Al-Ansari E, et al. Prevalence of depression, anxiety, and their associations among end-stage renal disease patients on maintenance hemodialysis: a multi-center population-based study. Psychol Health Med, 2020, 29: 1-9.
15.	Wu PH, Lin MY, Huang TH, et al. Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: a nationwide cohort study. PLoS One, 2019, 14(6): e0218335.
16.	Schouten RW, Haverkamp GL, Loosman WL, et al. Anxiety symptoms, mortality, and hospitalization in patients receiving maintenance dialysis: a cohort study. Am J Kidney Dis, 2019, 74(2): 158-166.
17.	Cao X, Chair SY, Wang X, et al. Self-care in Chinese heart failure patients: gender-specific correlates. Heart Lung, 2019, 48(6): 496-501.
18.	刘晓虹, 刘黎明. 维汉维持性血液透析患者自我管理状况及影响因素分析. 国际护理学杂志, 2015, 34(19): 2600-2604.
19.	Parker JR. Use of an educational intervention to improve fluid restriction adherence in patients on hemodialysis. Nephrol Nurs J, 2019, 46(1): 43-47.
20.	穆立芹, 李明明, 孙利军, 等. 认知行为干预在血液透析患者健康教育中的应用. 中国健康教育, 2017, 33(6): 569-572.
21.	Palmer SC, Hanson CS, Craig JC, et al. Dietary and fluid restrictions in CKD: a thematic synthesis of patient views from qualitative studies. Am J Kidney Dis, 2015, 65(4): 559-573.
22.	刘慧慧. 冠心病患者社会资源利用、积极度及自我管理行为的相关性研究. 天津: 天津中医药大学, 2018.
23.	Embuldeniya G, Veinot P, Bell E, et al. The experience and impact of chronic disease peer support interventions: a qualitative synthesis. Patient Educ Couns, 2013, 92(1): 3-12.
24.	马川寅, 施国婵, 梅游英. 微信病友群对血液透析患者治疗依从性的影响. 中国农村卫生事业管理, 2017, 37(9): 1095-1097.

1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266.
2. Isakova T, Nickolas TL, Denburg M, et al. KDOQI US commentary on the 2017 KDIGO clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Am J Kidney Dis, 2017, 70(6): 737-751.
3. Lin MY, Liu MF, Hsu LF, et al. Effects of self-management on chronic kidney disease: a meta-analysis. Int J Nurs Stud, 2017, 74: 128-137.
4. 李雪, 孙晓晶. 自我管理行为对维持性血液透析患者自我感受负担的影响研究. 中华护理杂志, 2016, 51(5): 562-566.
5. 陈彬. 医学多因素分析设计样本例数估算—多因素分析设计样本例数综合估算法. 伤害医学(电子版), 2012, 1(4): 58-60.
6. 李慧, 曹迎东, 姜亚芳, 等. 血液透析患者自我管理量表的引进及信效度检测. 中华护理杂志, 2015, 50(11): 1392-1395.
7. 李慧. 血液透析患者自我管理现状及影响因素的研究. 北京: 北京协和医学院 (清华大学医学部) & 中国医学科学院, 2011.
8. Wallston KA, Wallston BS, DeVellis R. Development of the multidimensional health locus of control (MHLC) scales. Health Educ Monogr, 1978, 6(2): 160-170.
9. Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs, 1992, 17(10): 1251-1259.
10. Glasgow RE, Toobert DJ, Barrera M Jr, et al. The chronic illness resources survey: cross-validation and sensitivity to intervention. Health Educ Res, 2005, 20(4): 402-409.
11. 华丽. 2 型糖尿病患者自我管理行为的社会生态模型: 结构方程模型的验证. 杭州: 浙江大学, 2010.
12. 刁贺. 老年维持性血液透析患者心理一致感、应对方式与自我管理行为相关研究. 延吉: 延边大学, 2020.
13. 程彦伶, 刘敏, 王丽丽, 等. 维持性血液透析患者自我管理行为、生活质量现状调查及相关性研究. 齐鲁护理杂志, 2020, 26(24): 37-40.
14. Al-Shammari N, Al-Modahka A, Al-Ansari E, et al. Prevalence of depression, anxiety, and their associations among end-stage renal disease patients on maintenance hemodialysis: a multi-center population-based study. Psychol Health Med, 2020, 29: 1-9.
15. Wu PH, Lin MY, Huang TH, et al. Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: a nationwide cohort study. PLoS One, 2019, 14(6): e0218335.
16. Schouten RW, Haverkamp GL, Loosman WL, et al. Anxiety symptoms, mortality, and hospitalization in patients receiving maintenance dialysis: a cohort study. Am J Kidney Dis, 2019, 74(2): 158-166.
17. Cao X, Chair SY, Wang X, et al. Self-care in Chinese heart failure patients: gender-specific correlates. Heart Lung, 2019, 48(6): 496-501.
18. 刘晓虹, 刘黎明. 维汉维持性血液透析患者自我管理状况及影响因素分析. 国际护理学杂志, 2015, 34(19): 2600-2604.
19. Parker JR. Use of an educational intervention to improve fluid restriction adherence in patients on hemodialysis. Nephrol Nurs J, 2019, 46(1): 43-47.
20. 穆立芹, 李明明, 孙利军, 等. 认知行为干预在血液透析患者健康教育中的应用. 中国健康教育, 2017, 33(6): 569-572.
21. Palmer SC, Hanson CS, Craig JC, et al. Dietary and fluid restrictions in CKD: a thematic synthesis of patient views from qualitative studies. Am J Kidney Dis, 2015, 65(4): 559-573.
22. 刘慧慧. 冠心病患者社会资源利用、积极度及自我管理行为的相关性研究. 天津: 天津中医药大学, 2018.
23. Embuldeniya G, Veinot P, Bell E, et al. The experience and impact of chronic disease peer support interventions: a qualitative synthesis. Patient Educ Couns, 2013, 92(1): 3-12.
24. 马川寅, 施国婵, 梅游英. 微信病友群对血液透析患者治疗依从性的影响. 中国农村卫生事业管理, 2017, 37(9): 1095-1097.

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Research on self-management behavior and influencing factors among maintenance hemodialysis patients

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