Promoting self-management improves the health status of patients having peritoneal dialysis

J Adv Nurs. 2009 Jul;65(7):1381-9. doi: 10.1111/j.1365-2648.2009.04993.x. Epub 2009 Apr 27.

Abstract

Aim: This paper is a report of a study conducted to explore the effects of promoting self-management on the well-being of patients having peritoneal dialysis.

Background: Peritoneal dialysis is a home-based treatment for end-stage renal disease. Promoting self-management has been shown to improve the health status of people with diabetes mellitus and other chronic diseases. However, little is known about the effects of self-management support for patients having peritoneal dialysis.

Method: Thirty patients who had received peritoneal dialysis for at least 6 months and were clinically stable were enrolled in the study in 2006. A multidisciplinary team was built to support the patients' self-management. Various forms of education such as group discussion and individual consultation were used to improve patients' self-efficacy and all were followed up for 6 months. We compared the volume status, adequacy of dialysis, nutritional status, quality of life, rehabilitation status, self-management capacity and self-efficacy levels at baseline, 3 and 6 months after enrolment.

Results: During follow-up, patients' urine volume and residual renal function decreased, while the adequacy of dialysis (Kt/v and Ccr) did not change. Volume status, quality of life and rehabilitation status all improved, whereas nutritional status did not deteriorate. Both self-management capacity and self-efficacy level increased statistically significantly.

Conclusion: A team approach needs to be taken to achieve successful self-management in patients having peritoneal dialysis, as with other chronic disease treatments. Nurses should use multiple strategies based on self-efficacy theory to improve patients' self-efficacy levels and self-management capacities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Status*
  • Home Care Services, Hospital-Based
  • Humans
  • Kidney Failure, Chronic / rehabilitation*
  • Male
  • Middle Aged
  • Nutritional Status*
  • Outcome Assessment, Health Care
  • Patient Care Team
  • Patient Education as Topic
  • Peritoneal Dialysis*
  • Quality of Life
  • Self Care / standards*
  • Urine