Journal of Kidney Treatment and Diagnosis

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The association of self-efficacy and self-management behavior in adult patients with chronic kidney disease: an integrative review

Author(s): Warissara Sorat*

Objectives: The objective of this integrative review was to examine the relationship between self-efficacy and self-management behavior in CKD patients and identify components of self-efficacy that may improve selfmanagement behavior in adults diagnosed with stage 1-5 CKD.

Background: Chronic kidney disease (CKD) is rising in prevalence worldwide, as shown by increases of attributive disease, as well as increases in incidence and prevalence of end-stage kidney disease. Best practice guidelines describe the beneficial outcomes of self-management intervention and indicate that a targeted self-management program is successful in enhancing patient selfmanagement and patient-centered outcomes. The essential elements of self-efficacy and self-management for CKD patients should be identified correctly in the early stage of CKD. However, it is not clear how to identify those relevant and sufficiently validated self-efficacy components that can lead to the development of a self-efficacy and self-management instrument or intervention suitable for patients with CKD. Design: An integrative literature review was conducted.

Methods: A search was conducted using CINAHL, PubMed/MEDLINE, Cochrane, ProQuest, Ovid, and Google Scholar. Published qualitative and quantitative studies, abstracts or dissertations describing the components and factors of self-efficacy associated with outcomes of self-management behaviors and interventions for people with CKD, and published in English between 2007 to 2017, were included. The associations were identified and described, and evidence was presented using Whittemore and Knafl’s framework [1] and Cooper’s method [2] to guide each stage of the review.

Results: Eighteen publications related to self-efficacy and self-management behaviors in patients with a variety of CKD stages were identified. Selfefficacy was mostly found to involve educational interventions. Educational, physical and psychological interventions to improve self-efficacy were evident, but few interventions led to significantly improved self-efficacy. Self-efficacy health contexts reflected in the studies were found as associations with selfmanagement behaviors related to management of CKD and its condition, adoption and maintenance of self-management behaviors, and mediation or modification of self-management behaviors to improve the effectiveness of self-care.

Conclusions: Various forms of self-efficacy can support self-management behaviors by persons with CKD. Understanding the function and concept of self-efficacy is important in developing simple and targeted implementations and supporting the efforts of CKD patients to manage their illness.


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