A Causal Relationship Model Between Characteristics, Knowledge, and Infection Prevention Behaviors for Coronavirus among Caregivers with End-Stage Renal Disease Patients Treated by Community Hospitals
Main Article Content
Abstract
This quantitative research aim investigated the relationship model between caregivers’ characteristics (ages and durations for care), knowledge, and infection prevention behaviors for Coronavirus among caregivers of end-stage renal disease patients treated at community hospitals. The sample consisted of 150 caregivers for caregivers of end-stage renal disease patients selected using purposive sampling. Data were collected using a questionnaire with a content validity index of 0.94, a reliability coefficient for knowledge of 0.71 obtained through the Kuder-Richardson method, and a reliability coefficient for infection prevention behaviors for Coronavirus of 0.93 via Cronbach’s alpha. Data analysis was performed using descriptive statistics and path analysis.
The results of this study were presented that the causal relationship between characteristics (ages and durations for care), knowledge, and infection prevention behaviors for Coronavirus among caregivers with end-stage renal disease patients was relevant with the empirical data (Chi-square = 1.00, GFI = 0.92, CFI = 0.94, NFI = 0.94, RMSEA = 0.00, RMR = 0.02). Caregivers’ characteristics (ages and durations for care) and their knowledge directly and indirectly affected to infection prevention behavior for Coronavirus, and 50% predictive power were presented. This study indicates that caregivers for end-stage renal disease patients is an important factor to infection prevention behaviors for Coronavirus. health services should support their understanding; therefore, caregivers can provide their care for End-Stage Renal Disease patients encountering with emerging infectious diseases in the future.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Adejumo, O. A., Iyawe, I. O., Akinbodewa, A. A., Abolarin, O. S., & Alli, E. O. (2019). Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients. Ghana medical journal, 53(3), 190–196.
Ailshire, J. A., & Crimmins, E. M. (2020). The impact of COVID-19 on home-based long-term care for older adults. The Gerontologist, 61(1), 78-90.
AlWakeel, J. S., & Bayoumi, M. M. (2016). Caregiver burden among peritoneal dialysis and hemodialysis family in Saudi Arabia. Kuwait Medical Journal, 48(3), 197–201.
Aman, Z., Liew, S. M., Ramdzan, S. N., Philp, I., & Khoo, E. M. (2020). The impact of caregiving on caregivers of older persons and its associated factors: a cross-sectional study. Singapore medical journal, 61(5), 238–245.
Bauza, V., Sclar, G. D., Bisoyi, A., Owens, A., Ghugey, A., & Clasen, T. (2021).Experience of the COVID-19 Pandemic in Rural Odisha, India: Knowledge, Preventative Actions, and Impacts on Daily Life. International Journal of Environmental Research and Public Health, 18(6), 2863.
Bevans, M., & Sternberg, E. M. (2012). Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. JAMA, 307(4), 398–403.
Bulusu, A., Segarra, C., & Khayat, L. (2023). Analysis of COVID-19 vaccine uptake among people with underlying chronic conditions in 2022: A cross-sectional study. SSM - Population Health, 22, 101422.
Beach, S. R., Schulz, R., Donovan, H., & Rosland, A. M. (2021). Family Caregiving During the COVID-19 Pandemic. The Gerontologist, 61(5), 650–660.
Cancarevic, I., Nassar, M., Daoud, A., Ali, H., Nso, N., Sanchez, A., Parikh, A., Ul Hosna, A., Devanabanda, B., Ahmed, N., & Soliman, K. M. (2022). Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis: A systematic review and meta-analysis. World journal of virology, 11(5), 352–361.
Cochran, W. G. (1977). Sampling techniques (3rd ed.). New York :John Wiley and Sons.
Chen, M. C., Kao, C. W., Chiu, Y. L., Lin, T. Y., Tsai, Y. T., Jian, Y. Z., Tzeng, Y. M., Lin, F. G., Hwang, S. L., Li, S. R., & Kao, S. (2017). Effects of home-based long-term care services on caregiver health according to age. Health and quality of life outcomes, 15(1), 208.
Chen, Y., Zhou, R., Chen, B., Chen, H., Li, Y., Chen, Z., Zhu, H., & Wang, H. (2020). Knowledge, Perceived Beliefs, and Preventive Behaviors Related to COVID-19 Among Chinese Older Adults: Cross-Sectional Web-Based Survey. Journal of medical Internet research, 22(12), e23729.
Faridah, V. N., Nursalam, N., Agustini, N. L. P. I. B., Lestari, T. P., Suratmi, S., Juanita, F., & Aris, A. (2020). Determinants of the caregiver burden of CKD patients undergoing hemodialysis. International Journal of Psychosocial Rehabilitation, 24(3), 6555-6565
Farzi, S., Farzi, S., Moladoost, A., Ehsani, M., Shahriari, M., & Moieni, M. (2019). Caring Burden and Quality of Life of Family Caregivers in Patients Undergoing Hemodialysis: A Descriptive-Analytic Study. International journal of community based nursing and midwifery, 7(2), 88–96.
Guerraoui, A., Idier, L., Hallonet, P., Dolley-Hitze, T., Gosselin, M., Duneau, G., Vendrely, B., Hirigoyen, M. D., Azzouz, L., Bouillier, M., Pelletier, S., Fouque, D., Fessi, H., De-Precigout, V., Vigneau, C., Kolko, A., Pinçon, É., Duquennoy, S., Delezire, A., Chantrel, F., … Prézelin-Reydit, M. (2021). Psychological impact of lockdown and the COVID-19 epidemic on hemodialysis patients and carers in France. Nephrologie & therapeutique, 17(4), 252–259.
Gupta, K. K., Attri, J. P., Singh, A., Kaur, H., & Kaur, G. (2016). Basic concepts for sample size calculation: Critical step for any clinical trials!. Saudi journal of anaesthesia, 10(3), 328–331.
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Ham, R. L. (2010). Multivariate data analysis (7th ed.). Prentice Hall.
Hejazi, S. S., Hosseini, M., Ebadi, A., & Khankeh, H. R. (2021). Components of quality of life in hemodialysis patients from family caregivers’ perspective: A qualitative study. BMC Nephrology, 22, 379.
Hsu, C. M., Weiner, D. E., Aweh, G., Miskulin, D. C., Manley, H. J., Stewart, C., Ladik, V., Hosford, J., Lacson, E. C., Johnson, D. S., & Lacson, E., Jr (2021). COVID-19 Among US Dialysis Patients: Risk Factors and Outcomes From a National Dialysis Provider. American journal of kidney diseases : the official journal of the National Kidney Foundation, 77(5), 748–756.e1.
Hoang, V. L., Green, T., & Bonner, A. (2019). Informal caregivers of people undergoing haemodialysis: Associations between activities and burden. Journal of Renal Care, 45(3), 151–158.
Indranoi, A., (2022). COVID-19 infection in An ESRD patient undergoing Chronic Peritoneal Dialysis: The first case report in Thailand. Region 11 Medical Journal, 36(2), 74–83.[In Thai].
Joy, J., T. J., H. K., Abraham, P. M., & Gopalakrishnan, S. (2019). Burden and resilience in caregivers of patients on maintenance haemodialysis. International Journal of Research in Medical Sciences, 7(11), 4033–4037.
Kasse T, Solomon T, Mesfin A, Lonsako AA, Orkaido O, Agegnehu Y and Haile A (2024) Awareness and infection prevention practices of hepatitis B virus among informal caregivers in public hospitals of Addis Ababa, Ethiopia, 2024.
Kim, J. K., & Crimmins, E. M. (2020). How does age affect personal and social reactions to COVID-19: Results from the national health and aging trends study. Public Health Reports, 135(4), 508-515
Kline, R. B. (2011). Methodology in the social sciences: principles and practice of structural equation modeling. (3rded.). Guilford Press.
Matthews, M., Reid, J., McKeaveney, C., & Noble, H. (2021). Knowledge Requirements and Unmet Needs of Informal Caregivers of Patients with End-Stage Kidney Disease (ESKD) Receiving Haemodialysis: A Narrative Review. Healthcare (Basel, Switzerland), 10(1), 57
McCaughey, D., McGhan, G., Flemons, K., Hindmarch, W., & Brundrit, K. (2022). Public Health Messaging during the COVID-19 Pandemic and Its Impact on Family Caregivers' COVID-19 Knowledge. Healthcare policy Politiques de sante, 18(1), 75–89.
Ministry of Public Health. (2022). Guidelines for the establishment and adjustment of service capacity levels of healthcare units, fiscal year 2022. Ministry of Public Health. Retrieved 28 December 2022. from https://phdb.moph.go.th/main/upload/ebook/web/20220207123639/. [In Thai].
Mohammadi, F., Farjam, M., Gholampour, Y., Sohrabpour, M., Oshvandi, K., & Bijani, M. (2021). Caregivers’ perception of the caring challenges in coronavirus crisis (COVID-19): A qualitative study. BMC Nursing, 20(1),102.1-9.
Nephrology Society of Thailand. (2020). Kidney replacement therapy in Thailand 2020. Retrieved 8 October 2023 from https://www.nephrothai.org/wp-content/uploads/2022/06/Final-TRT-report-2020.pdf. [In Thai].
Nephrology Society of Thailand & The Infectious Disease Association of Thailand. (2021). Guidelines for the care of patients with end-stage renal disease receiving hemodialysis during COVID-19 pandemic in Thailand. Retrieved 20 August 2021 from https://www.nephrothai.org/wp-content/uploads/2021/04/NST_COVID-19_09-04-21.pdf. [In Thai].
Nnama-Okechukwu, C. U., Chukwu, N. E., & Nkechukwu, C. N. (2020). COVID-19 in Nigeria: Knowledge and compliance with preventive measures. Social Work in Public Health, 35(7), 590–602.
Oh, Y.-J., & Song, Y.-S. (2019). The caregiver’s knowledge and practice about preventive behavior for urinary tract infection in long-term care facilities. Asia-Pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, 9(10), 407–421.
Oyegbile, Y. O., & Brysiewicz, P. (2017). Family caregiver's experiences of providing care to patients with End-Stage Renal Disease in South-West Nigeria. Journal of clinical nursing, 26(17-18), 2624–2632.
Rafati, F., Mashayekhi, F., & Dastyar, N. (2020). Caregiver burden and spiritual well-being in caregivers of hemodialysis patients. Journal of Religion and Health, 59(6), 3084–3096.
Savla, J., Roberto, K. A., Blieszner, R., McCann, B. R., Hoyt, E., & Knight, A. L. (2021). Dementia caregiving during the stay-at-home phase of the COVID-19 pandemic. The Journals of Gerontology: Series B, 76(4), e241–e245.
Sajadi, S., Ebadi, A., & Moradian, S. (2017). Quality of life among family caregivers of patients on hemodialysis and its relevant factors: A systematic review. International Journal of Community Based Nursing and Midwifery, 5(3), 206-218.
Shah, K. K., Murtagh, F. E. M., McGeechan, K., Crail, S., Burns, A., Tran, A. D., & Morton, R. L. (2020). Quality of life among caregivers of people with end-stage kidney disease managed with dialysis or comprehensive conservative care. BMC Nephrology, 21(1), 160.
Shen, F., Min, C., Lu, Y., & Chu, Y. (2021). The effect of cognition and affect on preventive behaviors during the COVID-19 pandemic: A cross-sectional study in China. BMC Public Health, 21(1), 722.
Sousa, H., Frontini, R., Ribeiro, O., Paúl, C., Costa, E., Amado, L., Miranda, V., Ribeiro, F., & Figueiredo, D. (2022). Caring for patients with end-stage renal disease during COVID-19 lockdown: What (additional) challenges to family caregivers?. Scandinavian journal of caring sciences, 36(1), 215–224.
World Health Organization. (2021). Coronavirus disease (COVID-19) advice for the public. Retrieved 8 September, 2021 from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
Van Lieshout, T. S., Vonk, S., Driehuis, E., Roeterdink, A. J., Goto, N. A., Vogels, T., Kooijman, W., Bart, J., Broese van Groenou, M. I., van Jaarsveld, B. C., & Abrahams, A. C. (2022). Exploring experiences and health-related quality of life of caregivers of patients who start home dialysis: study protocol for a prospective, multicentre cohort study. BMJ open, 12(11), e064172.
Valeri, A. M., Robbins-Juarez, S. Y., Stevens, J. S., Ahn, W., Rao, M. K., Radhakrishnan, J., Gharavi, A. G., Mohan, S., & Husain, S. A. (2020). Presentation and Outcomes of Patients with ESKD and COVID-19. Journal of the American Society of Nephrology, 31(7), 1409–1415
Yuan, J., & Grühn, D. (2018). Compromised cognitive functioning and well-being in informal caregiving: Caregiving duration matters. Innovation in Aging, 2(Suppl 1), 911.
Zhang, R., Pu, C., Cui, X., Zhang, N., Li, X., & Zheng, F. (2020). Burden in primary family caregivers caring for uremic patients on maintenance peritoneal dialysis. Peritoneal Dialysis International, 40(6), 556–562