Analysis of the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease_West China Medical Journal

Authors：

LIU Min , WANG Fang ,  DIAO Yongshu , MA Dengyan

Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DIAO Yongshu, Email: dszhbf@163.com

Keywords：

Non-dialysis patients; Chronic kidney disease; Self-care behavior; Social support; Anxiety; Depression

DOI：

10.7507/1002-0179.201912178

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Objective To investigate the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease (CKD).Methods A total of 336 patients with CKD were investigated by a general data questionnaire, the CKD Self-care Behavior Scale, Social Support Scale, Generalized Anxiety Self-assessment Scale, and 9-item Patients Health Questionnaire through WeChat platform, and the influencing factors of self-care behavior were explored by binary logistic regression analysis.Results The median score of self-care behavior of CKD patients without dialysis was 60, and the patients with median and high level of self-care behavior accounted for 97.6%. The score of self-care behavior of CKD patients without dialysis was positively correlated with the total score of social support (r=0.210, P<0.001), objective support score (r=0.127, P=0.020), subjective support score (r=0.195, P<0.001), and social support utilization score (r=0.164, P=0.002), and negatively correlated with the anxiety score (r=–0.132, P=0.015), depression score (r=–0.230, P<0.001), body mass index (r=–0.181, P=0.001), and systolic blood pressure (r=–0.168, P<0.001). The results of binary logistic regression analysis showed that the influencing factors of non-dialysis CKD patients’ self-care behavior were gender [(odds ratio, OR)=2.179, 95% confidence interval, CI (1.134, 4.187), P=0.019], systolic blood pressure [OR=0.967, 95%CI (0.947, 0.987), P=0.002], and depression score [OR=0.844, 95%CI (0.765, 0.931), P=0.001].Conclusions The self-care behavior of CKD patients without dialysis is at the median and high level. Healthcare workers can improve the self-care behavior of CKD patients by reducing their negative emotions such as depression, and guiding patients to carry out blood pressure management, to delay the progress of the disease.

Citation： LIU Min, WANG Fang, DIAO Yongshu, MA Dengyan. Analysis of the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease. West China Medical Journal, 2020, 35(11): 1357-1363. doi: 10.7507/1002-0179.201912178 Copy

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2.	Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
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4.	Wong G, Hayen A, Chapman JR, et al. Association of CKD and cancer risk in older people. J Am Soc Nephrol, 2009, 20(6): 1341-1350.
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15.	周蓉, 魏黎, 胡俊峰, 等. 家庭医生责任制管理的实施对社区高血压患者的影响. 上海医药, 2017, 38(22): 35-38.
16.	王历, 陆凯, 李建超, 等. 患者健康问卷在心血管门诊抑郁障碍筛查中的价值. 中华心血管病杂志, 2015, 43(5): 428-431.
17.	张新安. 低蛋白饮食对糖尿病肾病患者影响的研究进展分析. 饮食保健, 2018, 5(15): 31-32.
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19.	王淑丽, 陈慈徽, 龚兰芳, 等. 整体照护计划对CKD病人自我照顾行为与肾功能的影响. 长庚护理, 2018, 29(1): 1-13.
20.	李莉, 李英华, 聂雪琼, 等. 我国6省糖尿病患者自我管理行为调查. 中国健康教育, 2014, 30(1): 16-19, 38.
21.	何巧, 刘宇, 赵芳, 等. 新诊断2型糖尿病青年患者自我管理现状及影响因素研究. 护理学杂志, 2018, 33(11): 26-30.
22.	Rodriguez KM. Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator. Clin Ther, 2013, 35(2): 170-178.
23.	刘静, 王春梅. 2型糖尿病患者抑郁、焦虑与自我管理能力的相关性研究. 国际内分泌代谢杂志, 2013, 33(4): 283-286.
24.	沈玉兰, 夏世萍, 邹树芳. 老年2型糖尿病患者焦虑、抑郁水平与自我管理水平的相关性. 中国医药导报, 2017, 14(35): 151-154.
25.	张彩虹, 阳晓丽, 郭洪花, 等. 自我管理项目对社区慢性阻塞性肺疾病患者焦虑抑郁及疲劳的影响. 中国老年学杂志, 2017, 37(2): 436-438.
26.	Wang J, Xiong X. Control strategy on hypertension in Chinese medicine. Evid Based Complement Alternat Med, 2012(1): 284847.
27.	毛晓清, 黄秋鹏, 谢席胜, 等. 临床健康教育路径在慢性肾脏病合并高血压患者治疗中的应用. 西部医学, 2018, 30(2): 295-298.

1. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet, 2013, 382(9888): 260-272.
2. Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
3. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med, 2004, 351(13): 1296-1305.
4. Wong G, Hayen A, Chapman JR, et al. Association of CKD and cancer risk in older people. J Am Soc Nephrol, 2009, 20(6): 1341-1350.
5. 张路霞, 王海燕. 中国CKD的现状及挑战—来自中国CKD流行病学调查的启示. 中华内科杂志, 2012, 51(7): 497-498.
6. 徐红, 刘伟竹. 认识并延缓慢性肾脏病进展. 中华全科医师杂志, 2011(1): 71-72.
7. 幸露, 刁永书, 宋媛媛, 等. 慢性肾病早期病人自我管理行为与生活质量的关系研究. 护理研究, 2016, 30(35): 4377-4382.
8. 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): S1-266.
9. 王淑丽, 龚兰芳, 陈慈徽, 等. CKD人自我照顾行为量表之发展与信效度检验. 护理杂志, 2016, 63(4): 90-99.
10. 肖水源. 社会支持评定量表. 心理卫生评定量表手册(增订版). 北京: 中国心理卫生杂志社, 1999: 267-275.
11. 曲姗, 胜利. 广泛性焦虑量表在综合医院心理科门诊筛查广泛性焦虑障碍的诊断实验. 中国卫生心理杂志, 2015, 29(12): 939-944.
12. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder - The GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
13. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a serfreport version of PRIMEMD: the PHQ primary care study. JAMA, 1999, 282(18): 1737-1744.
14. 中国医学会心血管病学分会高血压血组. 清晨血压临床管理中国专家指导建议. 中华心血管病杂志, 2014, 42(9): 721-725.
15. 周蓉, 魏黎, 胡俊峰, 等. 家庭医生责任制管理的实施对社区高血压患者的影响. 上海医药, 2017, 38(22): 35-38.
16. 王历, 陆凯, 李建超, 等. 患者健康问卷在心血管门诊抑郁障碍筛查中的价值. 中华心血管病杂志, 2015, 43(5): 428-431.
17. 张新安. 低蛋白饮食对糖尿病肾病患者影响的研究进展分析. 饮食保健, 2018, 5(15): 31-32.
18. Pagels AA, Söderkvist BK, Medin C, et al. Health-related quality of life in different stages of chronic kidney disease and at initiation of dialysis treatment. Health Qual Life Outcomes, 2012, 10(1): 71.
19. 王淑丽, 陈慈徽, 龚兰芳, 等. 整体照护计划对CKD病人自我照顾行为与肾功能的影响. 长庚护理, 2018, 29(1): 1-13.
20. 李莉, 李英华, 聂雪琼, 等. 我国6省糖尿病患者自我管理行为调查. 中国健康教育, 2014, 30(1): 16-19, 38.
21. 何巧, 刘宇, 赵芳, 等. 新诊断2型糖尿病青年患者自我管理现状及影响因素研究. 护理学杂志, 2018, 33(11): 26-30.
22. Rodriguez KM. Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator. Clin Ther, 2013, 35(2): 170-178.
23. 刘静, 王春梅. 2型糖尿病患者抑郁、焦虑与自我管理能力的相关性研究. 国际内分泌代谢杂志, 2013, 33(4): 283-286.
24. 沈玉兰, 夏世萍, 邹树芳. 老年2型糖尿病患者焦虑、抑郁水平与自我管理水平的相关性. 中国医药导报, 2017, 14(35): 151-154.
25. 张彩虹, 阳晓丽, 郭洪花, 等. 自我管理项目对社区慢性阻塞性肺疾病患者焦虑抑郁及疲劳的影响. 中国老年学杂志, 2017, 37(2): 436-438.
26. Wang J, Xiong X. Control strategy on hypertension in Chinese medicine. Evid Based Complement Alternat Med, 2012(1): 284847.
27. 毛晓清, 黄秋鹏, 谢席胜, 等. 临床健康教育路径在慢性肾脏病合并高血压患者治疗中的应用. 西部医学, 2018, 30(2): 295-298.

West China Medical Journal

Analysis of the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease

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