The Effect of a Self-Management Behavior Promoting Program for Delayed Progression of Kidney Disease and Clinical Outcomes in Patients with Chronic Kidney Disease Stage 3

Abstract

Chronic kidney disease is a global public health challenge. In Thailand the disease is also associated with increased mortality risk among affected individuals. This quasi-experimental design aimed to evaluate the effects of a self-management behavior promoting (SMBP) program for delaying the progression of kidney disease and clinical outcomes in patients with chronic kidney disease (CKD) stage III. The samples were composed of 40 diabetes mellitus (DM) and hypertension (HT) patients who were treated at the noncommunicable disease (NCD) clinic, Prathum Health Promoting Hospital, Mueang Ubon Ratchathani District, Ubon Ratchathani Province. The samples were selected using the purposive sampling technique. The patients received the SMBP program, a home visit, and a follow-up for 12 weeks. A structured questionnaire was used to assess the patients' knowledge about chronic kidney disease, including their behavior or self-awareness to delay the disease. The Cronbach^, s Alpha reliabilities were 0.80 and 0.86 respectively and estimated glomerular filtration rate (eGFR) was used to measure their kidney function. The data were analyzed using descriptive statistics and a paired t-test. The results revealed that after the intervention, the DM and HT subjects had significantly higher average scores of knowledges and self-management behavior than before the intervention (p < 0.05 and p < 0.05, respectively).  In addition, most of the subjects had stable eGFR (57.5%) and increased eGFR (25%). However, the mean increase in eGFR was not different between before and after the intervention (P > 0.05). The SMBP program was found to be effective in changing perceived self-efficacy in self-management behavior for delaying the progression of kidney disease. However, the mean change in eGFR was not different between before and after the intervention. This SMBP program should be continued in NCD clinics to improve self-management behavior and delay the progression of kidney disease.