Study On The Influence Of Nursing Intervention On The Self-management And Health Status Of Patients With Chronic Kidney Disease

Objectives1.To establish and evaluate the reliability and the validity of the chronic kidney disease(CKD) patients’ self-management scale;2.To investigate the self-management status and the influence factors in CKD patients;3.To investigate the health status of patients with CKD, and to study the relationship between the self-management level and the health status among these patients;4.To explore the influence of nursing intervention on the Self-management and health status of CKD patients.MethodsA convenient sample of96chronic kidney disease patients in Tianjin Medical University General Hospital during October2010to September2011was taken. The study population was divided into the intervention group and the control group.Dates were collected by self-designed personal characteristics questionnaire, self-designed CKD self-management scale, and the Short-Form Health Survey(SF-36). Then the self-management intervention was used in intervention group, and general guidance was used in control group. After6months, the data from two groups was collected again, which was analysised by SPSS16.0.Mean plus-minus standard deviation and percentage were used in descriptive information. One way analysis of variance and multiple stepwise regressions were used in self-management influencing factors analysis. And the independent-samples t-test、the paired-samples t-test、Chi-square tests and Pearson correlation analysis were used.Results1.Reliability and validity of the CKD self-management scale:(1)Reliability of the scale:the overall scale Cronbach’s a coefficient was0.902, the test-retest correlation coefficient was0.898.(2)Validity of the scale:the CVI for the overall scale was0.901, it was confirmed that the structure of the scale was matched with the theoretical construction.2.The overall score of self-management was (86.59±11.45)points, score indicator was69.57%.3.The scores of all the dimensions of the SF-36were markedly lower than the general population(P<0.01).4.Patients’education level、family income per month、history、and complications are the major factors influence CKD patients self-management by multiple stepwise regression.5.It had positive correlation between self-management and SF-36of CKD patients. It had moderate correlation between the physical activity self-management, overall self-management and SF-36.It had low correlation between the factors of diet self-management, treatment self-management, social psychology self-management and SF-36.6. Six months after the intervention, whether the intervention group compared with control group or itself, the scores of the self-management of CKD patients were improved(P<0.01),and so did the patients’health status and biochemical indicator (P<0.05).Conelusion1.The self-management scale had well reliability and validity.2.The levels of self-management among CKD patients were between moderate and low levels, still need to be improved.3.The CKD patients’health statuses are not good,still need to be enhanced.4.It has positive correlation between the self-management and health status of the patients with CKD, the higher of self-management level, the better of their health.5.Patients’education level、family income per month、history、and complications are the major factors influence their self-management.6.The CKD patients’self-management、health status and biochemical indicator can be improved differently by self-management intervention which also improved the patients’quality of life.