Meeting patients where they are: improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study)
Meeting patients where they are: improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study)
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DOI：
10.1186/s12882-018-1075-2
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发表时间：
2018-10-20
期刊：
影响因子：
2.3
通讯作者：
Bonner, Ann
中科院分区：
文献类型：
--
作者：
Havas, Kathryn;Douglas, Clint;Bonner, Ann
为了达到最佳的健康结果，慢性肾脏疾病患者必须改变日常生活，以自我管理他们的病情。这可能具有挑战性，需要自我管理支持干预措施，帮助人们成为成功的自我管理者。虽然已经制定了干预措施，但这方面的文献很少，而且由于缺乏个性化和健全的理论基础而受到限制。本研究的目的是实施和评估慢性肾脏病自我管理支持干预：一个以理论为基础的，以人为中心的自我管理干预的人与慢性肾脏疾病阶段1- 4。方法一个单一的样本，前后研究的个性化，基于社会认知理论和个人原则的12周干预，在澳大利亚昆士兰州的门诊肾脏诊所对患者进行集中护理（N=66）。在T0（干预前）和T1（干预后）收集数据。主要结果是自我效能和自我管理behaviors.ResultsThere有显着的，小到中等的改善，在主要成果（自我效能：平均差异+0.8，95%CI 0.3-1.2，d=0.4;自我管理行为：平均差异+6.2，95%CI 4.5-7.9，d=0.8）。次要结局（血压、疾病特异性知识、体力活动、水果和蔬菜消费、饮酒、健康相关生活质量、心理困扰和与医疗保健提供者的沟通）有进一步的显著改善，效应量从可忽略到很大（所有P
BackgroundTo achieve optimal health outcomes, people with chronic kidney disease must make changes in their everyday lives to self-manage their condition. This can be challenging, and there is a need for self-management support interventions which assist people to become successful self-managers. While interventions have been developed, the literature in this area is sparse and limited by lack of both individualisation and sound theoretical basis. The aim of this study was to implement and evaluate the Chronic Kidney Disease-Self-Management Support intervention: a theory-based, person-centred self-management intervention for people with chronic kidney disease stages 1-4.MethodsA single-sample, pre-post study of an individualised, 12-week intervention based upon principles of social-cognitive theory and person-centred care was conducted with patients attending outpatient renal clinics in Queensland, Australia (N=66). Data were collected at T0 (pre-intervention) and T1 (post-intervention). Primary outcomes were self-efficacy and self-management behaviour.ResultsThere were significant, small-to-medium improvements in primary outcomes (self-efficacy: mean difference+0.8, 95% CI 0.3-1.2, d=0.4; self-management behaviour: mean difference+6.2, 95% CI 4.5-7.9, d=0.8). There were further significant improvements in secondary outcomes (blood pressure, disease-specific knowledge, physical activity, fruit and vegetable consumption, alcohol consumption, health-related quality of life, psychological distress, and communication with healthcare providers), with effect sizes ranging from negligible to large (all ps