Effects of case management nursing activities on selected outcomes in patients with chronic kidney disease with rapid decline of kidney function

Abstract

This experimental research aimed to study the effects of case management nursing activities on selected outcomes in patients with chronic kidney disease with rapid decline of kidney function. The sample group was patients with chronic kidney disease stage 3 who had rapidly declining kidney function. The sample group was randomly assigned to the experimental group and the control group using simple random sampling with a non-returnable lottery. The lottery was drawn twice: the first time, the names of eligible patients were randomly drawn without returning to obtain a sample of 60 patients; and the second time, the list of 60 patients in the sample was randomly assigned to the experimental group or the control group, 30 patients for each group. The research period was 12 weeks. The research instruments consisted of 1) The tools for data collection: a demographic questionnaire, a laboratory test result record form, and an assessment form for self-management behavior to delay kidney failure. The instrument was verified by five experts and obtained the content validity index of 0.81. The reliability test revealed Cronbach’s alpha coefficient of 0.84. 2) The instruments used in the experiment, which included 2.1) the guidelines for case management nursing activities in caring for patients with chronic kidney disease stage 3 with rapid decline in kidney function (Clinical pathway), 2.2) case management nursing activities in patients with chronic kidney disease stage 3 with rapid decline in kidney function, 2.3) an assessment form of risk factors for rapid decline in glomerular filtration rate in patients with chronic kidney disease, 2.4) a referral for consulting with the health team record form, 2.5) the self-management manual for patients with chronic kidney disease to delay kidney failure, and 2.6) the case management record form for patients with chronic kidney disease with rapid kidney failure (for nurses). The content validity of the instruments 2.2-2.6 were 0.82, 1.00, 0.84, and 1.00, respectively.

The demographic data were analyzed using descriptive statistics. The scores of self-management behaviors to delay kidney failure, glomerular filtration rate, and microalbumin in urine were compared between the experimental and control groups using the Mann-Whitney U test.

The results found that after receiving the case management nursing activities, the experimental group had mean scores of dependent variables (self-management behaviors to delay kidney failure, glomerular filtration rate, and microalbumin in urine) that were significantly different from the control group (p<.01). This indicates that case management nursing activities can help patients with chronic kidney disease to have self-management behaviors to delay kidney failure, resulting in better clinical outcomes.