Self-efficacy and home dialysis: An integrative review

Background: Enhancing patient confidence in their ability (self-efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self-efficacy in patients managing home dialysis.

Objectives: To identify self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in patients undergoing home dialysis.

Design: An integrative review approach was employed using Whittemore and Knafl's methodology.

Methods: A comprehensive search was conducted to identify literature on self-efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and Scopus databases without a date limit. The included literature was critically appraised for methodological quality. Data extraction was conducted to report the study characteristics, measurement tools used and interventions conducted along with the synthesis of findings in a narrative format.

Results: Fifteen studies were included in the review were predominantly quantitative examining training programmes promoting self-efficacy in adults conducting home dialysis. The finding that self-efficacy builds over time was structured into two themes; gaining skills to develop self-efficacy and building and maintaining knowledge of self-efficacy.

Conclusion: The findings highlighted the importance of employing multifaceted strategies with support from health professionals including nurses, families and peer support to develop self-efficacy in patients undergoing home dialysis.