scholarly journals Patients’ and healthcare professionals’ beliefs, perceptions and needs towards chronic kidney disease self-management in China: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044059
Author(s):  
Hongxia Shen ◽  
Rianne M J J van der Kleij ◽  
Paul J M van der Boog ◽  
Wenjiao Wang ◽  
Xiaoyue Song ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Healthcare Professionals ◽  
Illness Perceptions ◽  
Chinese Patients ◽  
Self Management ◽  
Tertiary Referral Hospital ◽  
Chinese Context ◽  
Management Interventions

ObjectivesTo support the adaptation and translation of an evidence-based chronic kidney disease (CKD) self-management intervention to the Chinese context, we examined the beliefs, perceptions and needs of Chinese patients with CKD and healthcare professionals (HCPs) towards CKD self-management.DesignA basic interpretive, cross-sectional qualitative study comprising semistructured interviews and observations.SettingOne major tertiary referral hospital in Henan province, China.Participants11 adults with a diagnosis of CKD with CKD stages G1–G5 and 10 HCPs who worked in the Department of Nephrology.ResultsFour themes emerged: (1) CKD illness perceptions, (2) understanding of and motivation towards CKD self-management, (3) current CKD practice and (4) barriers, (anticipated) facilitators and needs towards CKD self-management. Most patients and HCPs solely mentioned medical management of CKD, and self-management was largely unknown or misinterpreted as adherence to medical treatment. Also, the majority of patients only mentioned performing disease-specific acts of control and not, for instance, behaviour for coping with emotional problems. A paternalistic patient–HCP relationship was often present. Finally, the barriers, facilitators and needs towards CKD self-management were frequently related to knowledge and environmental context and resources.ConclusionsThe limited understanding of CKD self-management, as observed, underlines the need for educational efforts on the use and benefits of self-management before intervention implementation. Also, specific characteristics and needs within the Chinese context need to guide the development or tailoring of CKD self-management interventions. Emphasis should be placed on role management and emotional coping skills, while self-management components should be tailored by addressing the existing paternalistic patient–HCP relationship. The use of electronic health innovations can be an essential facilitator for implementation.

scholarly journals Patient empowerment through a user-centered design of an electronic personal health record: a qualitative study of user requirements in chronic kidney disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Esmaeel Toni ◽  
Habibollah Pirnejad ◽  
Khadijeh Makhdoomi ◽  
Azam Mivefroshan ◽  
Zahra Niazkhani
Keyword(s):  
Chronic Kidney Disease ◽  
Health Literacy ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Personal Health Record ◽  
Self Management ◽  
Personal Health ◽  
Health Record ◽  
User Centered Design ◽  
Electronic Personal Health Record

Abstract Background To improve chronic disease outcomes, self-management is an effective strategy. An electronic personal health record (ePHR) is a promising tool with the potential to support chronic patient’s education, counseling, and self-management. Fitting ePHRs within the daily practices of chronic care providers and chronic patients requires user-centered design approaches. We aimed to understand users’ needs and requirements in chronic kidney disease (CKD) care to consider in the design of an ePHR to facilitate its implementation, adoption, and use. Methods A qualitative study was conducted in a major Iranian nephrology center including inpatient and outpatient settings in 2019. We conducted 28 semi-structured interviews with CKD patients, nurses, and adult nephrologists. To confirm or modify the requirements extracted from the interviews, a focus group was also held. Data were analyzed to extract especially those requirements that can facilitate implementation, adoption, and sustained use based on the PHR adoption model and the unified theory of acceptance and use of technology. Results Participants requested an ePHR that provides access to up to date patient information, facilitates patient-provider communication, and increases awareness about patient individualized conditions. Participants expected a system that is able to cater to low patient e-health literacy and high provider workload. They requested the ePHR to include purposeful documentation of medical history, diagnostic and therapeutic procedures, tailored educational content, and scheduled care reminders. Messaging function, tailored educational content to individual patients’ conditions, and controlled access to information were highly valued in order to facilitate its implementation, adoption, and use. Conclusions We focused on the ePHR’s content and functionalities in the face of facilitators and/or barriers envisioned for its adoption in nephrology care. Designers and implementers should value CKD patients’ needs and requirements for self-management such as providing personalized education and counseling (on the basis of their condition and risk factors), health literacy, and disease progression levels. The socio-technical aspects of care also need further attention to facilitate ePHR’s adoption.

scholarly journals Self-management interventions for chronic kidney disease: a systematic review and meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Suyuan Peng ◽  
Jiawei He ◽  
Jiasheng Huang ◽  
Longwei Lun ◽  
Jiahao Zeng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Self Management ◽  
Management Interventions

scholarly journals Electronic Health Self-Management Interventions for Patients With Chronic Kidney Disease: Systematic Review of Quantitative and Qualitative Evidence

10.2196/12384 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e12384 ◽  
Author(s):  
Hongxia Shen ◽  
Rianne M J J van der Kleij ◽  
Paul J M van der Boog ◽  
Xinwei Chang ◽  
Niels H Chavannes
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Management ◽  
Self Management ◽  
Health Improvement ◽  
Management Skills ◽  
Outcome Indicators ◽  
Positive Effects ◽  
Management Interventions ◽  
Electronic Health

Background Chronic kidney disease (CKD) poses a major challenge to public health. In CKD patients, adequate disease self-management has been shown to improve both proximal and distal outcomes. Currently, electronic health (eHealth) interventions are increasingly used to optimize patients’ self-management skills. Objective This study aimed to systematically review the existing evidence regarding the implementation and effectiveness of eHealth self-management interventions for patients with CKD. Methods Following a search in 8 databases (up to November 2017), quantitative and qualitative data on process and effect outcomes were extracted from relevant studies. Quality was appraised using the Crowe Critical Appraisal Tool; narrative synthesis was performed to analyze the data extracted. Results Of the 3307 articles retrieved, 24 (comprising 23 studies) were included in this review; of these, almost half were appraised to be of low to moderate quality. There was considerable heterogeneity in the types of interventions used and the outcomes measured. A total of 10 effect and 9 process outcome indicators were identified. The most frequently reported effect outcome indicators were specific laboratory tests and blood pressure (BP), whereas satisfaction was the most frequently reported process outcome indicator. Positive effects were found for proximal outcomes (eg, BP control and medication adherence), and mixed effects were found for more distal outcomes (eg, quality of life). High feasibility, usability, and acceptability of and satisfaction with eHealth self-management interventions were reported. The determinant ability of health care professionals to monitor and, if necessary, anticipate on patient measurements online was mostly cited to influence patients’ adherence to interventions. Conclusions eHealth self-management interventions have the potential to improve disease management and health outcomes. To broaden the evidence base and facilitate intervention upscaling, more detailed descriptions and thorough analysis of the intervention components used are required. In addition, our review reveals that outcomes closely related to the scope and duration of the intervention implemented are most likely to be impacted. For instance, if a 4-week Web-based training to optimize disease management skills is implemented, the outcome perceived control would more likely be affected than kidney function. Although this seems obvious, most studies evaluate only distal outcomes and thereby fail to capture intervention effects that might contribute to long-term health improvement. We advise future researchers to carefully consider their choice of outcomes based on their sensitivity for change. In this way, we ensure that relevant effects are captured and legitimate conclusions are drawn.

The Effects of Self-Management Interventions on the Health Outcomes of Individuals With Chronic Kidney Disease After Critical Illness: An Integrative Review

2019 ◽  
Vol 13 (3) ◽  
pp. 126-144
Author(s):  
Claudia Leung Ho Yau ◽  
Janita Chau Pak Chun
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Outcomes ◽  
English Language ◽  
Well Being ◽  
Management Program ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is a crucial step towards achieving better physical and mental well-being and a better health-related quality of life for individuals with chronic kidney disease (CKD). Despite the high prevalence of CKD and the significant burdens faced by the individuals with CKD, their caregivers, and healthcare systems, very few studies have explored CKD and its consequences compared to other chronic diseases.ObjectiveTo synthesize and present the best available evidence on the effectiveness of CKD self-management interventions in terms of the biomedical, psychosocial, and behavioral aspects of health outcomes.MethodsThree electronic English-language literature databases were searched from inceptions to March 2018. Two reviewers independently selected articles according to pre-specified criteria, critically appraised and extracted data from relevant research. Narrative summaries were presented because the interventions and study features of the included articles were heterogeneous.ResultsOf the five included articles, three were interventional and two were systematic reviews. Effective self-management interventions have beneficial effects on biomedical outcomes such as blood pressure, psychosocial outcomes such as quality of life and self-efficacy, and behavioral outcomes such as CKD knowledge, self-management techniques, and adherence to self-care regimens and treatments.ConclusionsA self-management program that could provide better education and guidance for individuals with CKD is needed, as this would improve the provision of resources and preparations for foreseeable and avoidable CKD complications. The findings from the included articles demonstrate that limited amount of research has focused on CKD management. Additional randomized controlled trials that compare interventions with usual care are needed to determine the efficacy of CKD self-management programs.

scholarly journals Patient-Centered Self-Management in Patients with Chronic Kidney Disease: Challenges and Implications

2020 ◽  
Vol 17 (24) ◽  
pp. 9443
Author(s):  
Chiu-Chu Lin ◽  
Shang-Jyh Hwang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Management ◽  
Future Research ◽  
Primary Study ◽  
Patient Centered ◽  
Positive Effects ◽  
Management Interventions ◽  
Unsuccessful Treatment ◽  
Technology Intervention

This review aims to identify attributes of patient-centered self-management (PCSM) in the current literature and explore its implementation in resolving patient obstacles in chronic kidney disease (CKD) treatment and management. A search of relevant articles and literature on PCSM, integrated care, and challenges of CKD management was conducted. Vital attributes of PCSM and current self-management interventions employed to resolve patient obstacles in CKD management were identified from inclusion studies. Findings affirm that PCSM strategies have positive effects on CKD management, but a lack of quality primary study, and long-term evidence presents the need for further development. Future research should focus on the development of a standardized and universal integrated PCSM model and a uniform system of data collection in the clinical setting. The difficulty of CKD management lies in how it is a comorbid and progressive disease. A pure biomedical approach is inadequate. Our review recommends that an integrated PCSM approach with health literacy and information technology intervention, which unifies and integrates patient education, can address the difficulties that are contributing to unsuccessful treatment outcomes. An integrated PCSM model should be implemented systematically and methodologically into future CKD management and health policies.

scholarly journals Self-Management Interventions in Stages 1 to 4 Chronic Kidney Disease

2014 ◽  
Vol 37 (5) ◽  
pp. 652-678 ◽  
Author(s):  
Janet L. Welch ◽  
Michelle Johnson ◽  
Lani Zimmerman ◽  
Cynthia L. Russell ◽  
Susan M. Perkins ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Management ◽  
Management Interventions

The self-management experience of patients with type 2 diabetes and chronic kidney disease: A qualitative study

2015 ◽  
Vol 12 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Shayan Shirazian ◽  
Natalie Crnosija ◽  
Katie Weinger ◽  
Alan M Jacobson ◽  
Joonho Park ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Qualitative Study ◽  
The Self ◽  
Self Management ◽  
Management Experience

scholarly journals A Qualitative Study of Facilitators and Barriers to Self-management of Chronic Kidney Disease

2021 ◽  
Author(s):  
Sarah J. Schrauben ◽  
Eleanor Rivera ◽  
Claire Bocage ◽  
Whitney Eriksen ◽  
Sandra Amaral ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Self Management ◽  
Facilitators And Barriers

scholarly journals Characterizing Illness Perception Phenotypes in Older Adults With Chronic Kidney Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 779-779
Author(s):  
Eleanor Rivera ◽  
Karen Hirschman ◽  
Raymond Townsend
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Adherence ◽  
Illness Perceptions ◽  
Illness Perception ◽  
Patient Activation ◽  
Personality Type ◽  
Self Management ◽  
Disease Knowledge

Abstract An individual’s understanding of their chronic illness (illness perception) is a psychological resource that has an impact on coping and self-management behaviors. Our previous study identified illness perception phenotypes (overall patterns of illness perceptions) in a sample of older adults with heart failure, COPD, and chronic kidney disease. These phenotypes were associated with perceived self-management ability (patient activation) and recent hospitalizations. To further characterize the illness perception phenotypes we focused on older adults with chronic kidney disease, analyzing illness perception data along with potential covariates from the multi-center longitudinal Chronic Renal Insufficiency Cohort study (CRIC). Covariates include sociodemographics, disease parameters, personality type, disease knowledge, and treatment adherence. While personality type was associated with illness perception phenotype, disease knowledge and treatment adherence were not. We have also conducted qualitative analyses of in-depth interviews. These results will inform the development of a pilot intervention incorporating illness perception information into the clinical setting.

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