Patient activation with knowledge, self-management and confidence in chronic kidney disease

J Ren Care. 2016 Mar;42(1):15-22. doi: 10.1111/jorc.12142. Epub 2015 Nov 5.


Background: Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease.

Objectives: This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease.

Design: The study employed a descriptive correlational design.

Settings: Participants were recruited from five primary care, three nephrology clinics and one dialysis centre in two Midwestern cities in the United States.

Participants: The convenience sample included 85 adults with hypertension, diabetes mellitus and chronic kidney disease, including kidney failure, who spoke English.

Measurements: Seven measurements were used to collect data via telephone interviews with participants not receiving haemodialysis, and face-to-face interviews with those receiving haemodialysis at the beginning of their treatment session.

Results: Analyses indicated that half the participants were female (50.58%), the mean age was 63.21 years (SD = 13.11), and participants with chronic kidney disease stage 3 were the most activated. Post hoc differences were significant in patient activation and blood pressure self-management and anxiety across chronic kidney disease stages, excluding stage 5.

Conclusion: Engaging patients in the self-management of their health care and enhancing patients' ability to self-manage their blood pressure may work to preserve kidney health. Healthcare providers should collaborate with patients to develop strategies that will maintain patients' health-related quality of life, like reducing anxiety as kidney disease progress.

Keywords: Chronic kidney disease; Health-related quality of life; Patient activation; Self-management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Patient Participation*
  • Quality of Life
  • Renal Insufficiency, Chronic / therapy*
  • Self Care*
  • Self Concept
  • United States