Zone Tool: Improving Self-Care and Self-Efficacy among Patients with Chronic Kidney Disease

Azza Fathi Ibrahim Mohammed^1, , Thoraya Mohammed Abdel Aziz² and Ola Ezzat Eltohamy³

¹Nursing Education Department, Faculty of Nursing, Alexandria University, Egypt

²Medical-Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt

³Gerontology Nursing Department, Faculty of Nursing, Damanhur University, Egypt

Cite this paper:
Azza Fathi Ibrahim Mohammed, Thoraya Mohammed Abdel Aziz and Ola Ezzat Eltohamy. Zone Tool: Improving Self-Care and Self-Efficacy among Patients with Chronic Kidney Disease. American Journal of Nursing Research. 2020; 8(6):608-623. doi: 10.12691/ajnr-8-6-4

Abstract

Chronic Kidney Disease (CKD) mortality has increased in Egypt; consequently, comprehensive health education is necessitated. This study aimed to: develop and employ, then, evaluate the developed zone tool as a health education strategy on CKD patients’ self-care management and self-efficacy levels. A methodological design was implemented. Two hundred patients with CKD were randomly assigned as an assessment group, then, by systematic random sampling; 30% of them, were recruited as an experimental group. Three tools were used for data collection: Tool one: Patient's sociodemographic and clinical characteristics questionnaire, Tool two: CKD Self-Management Instrument, and Tool three: Self-Efficacy for Managing Chronic Disease Six-Item Scale. Results for the assessment group showed an obvious low level in self-care management and self-efficacy perceptions. After using the developed zone tool among the experimental group; the findings revealed little improvement in clinical characteristic’s values, and considerable improvement in self-care management and self-efficacy perception levels within 1st, 2nd, to 3rd assessments. Conclusion: the developed zone tool is a crucial educational approach to improve CKD patient’s self-care management, and self-efficacy perception levels. Recommendations and further studies: interdisciplinary involvement should be integrated into developing comprehensive and valid CKD health education materials. Evaluation of health education’ compliance among CKD patients is a required study.

Keywords:
Chronic Kidney disease (CKD) Health education tools Patient's self-care management and Self-efficacy

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Lin, C., Wu, C., Wu, L., Chen, H., & Chang, S. Psychometric evaluation of a new instrument to measure disease self-management of the early stage chronic kidney disease patients. Journal of Clinical Nursing 2013, 22(7-8), 1073-1079.
[2]	Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. Effect of a self-management program on patients with chronic disease. Effective clinical practice, 2001; 4(6), 256-262.
[3]	Health Quality Ontario. Specialized Nursing Practice for Chronic Disease Management in the Primary Care Setting: An Evidence-Based Analysis. Ont Health Technol Assess Ser. 2013; 13(10): 1-66.
[4]	Fathi A. Development of Patient Health Education Model to Guide Undergraduate Nursing Students. Unpublished MSN Thesis. Alexandria: University of Alexandria, Faculty of Nursing 2006: 23-37.
[5]	Bodenheimer T. Partnering in Self-Management Support: A Toolkit for Clinicians: Helping Patients Manage Their Chronic Conditions. Institute for Healthcare Improvement 2009; 1-34.
[6]	Tung H., Lin C., Chen K., Chang C. Lin Y., Chou C. Self-Management Intervention to Improve Self-Care and Quality of Life in Heart Failure Patients Congest Heart Fail 2013; 19(40) E10-E16.
[7]	Rivera E, Corte C, Steffen A, DeVon HA, Collins EG, McCabe PG. Illness Representation and Self-Care Ability in Older Adults with Chronic Disease. Geriatrics (Basel) 2018; 3(3): 45.
[8]	Belil FE, Alhani F,Ebadi A, Kazemnejad A. Self-Efficacy of People with Chronic Conditions: A Qualitative Directed Content Analysis. J Clin Med. 2018; 7(11): 411.
[9]	Mohamadinejad F., Razi S.P., Aliasgharpour M., Tabari F. Effect of patient education program on self-efficacy in patients with diabetes. Iran. J. Med. Educ. 2015; 10: 35-41.
[10]	Al Sebaee HA, Abdel Aziz EM, Mohamed NT. Relationship between Nursing Students’ Clinical Placement Satisfaction, Academic Self-Efficacy and Achievement. IOSR Journal of Nursing and Health Science 2017; 6(2) 101-112. (IOSR-JNHS) e-ISSN: 2320-1959.p- ISSN: 2320-1940.
[11]	Abd El Hafeez S, Bolignano D, D'Arrigo G, Dounousi E, Tripepi G, Carmine C. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review. BMJ Open 2018; 8: e015069.
[12]	Abd Elaziz KM, Gabal MS, Aldafrawy OA, Abou Seif HA, Allam MF. Prevalence of metabolic syndrome and cardiovascular risk factors among voluntary screened middle-aged and elderly Egyptians 2015; Journal of Public Health, 27(4). 612-617.
[13]	Romagnani P, Remuzzi G, Levin A, Jager KJ. Chronic kidney disease. Hans-Joachim Anders 2017. available at: https://www.researchgate.net/publication/321253641_Chronic_kid ney_disease retrieved in November 201.
[14]	Gouda Z, Mashaal G, Aminu K, Bello G, Attar A, El Kemmry T, El RewenyA, El Nahas M. Egypt Information, Prevention, and Treatment of Chronic Kidney Disease (EGIPT-CKD) Programme: Prevalence and Risk Factors for Microalbuminuria among the Relatives of Patients with CKD in Egypt. Saudi J Kidney Dis Transpl 2011; 22(5):1055-1063.
[15]	Horwitz L, Krumholz H, Hunt S, Yeon S, Villalba C. Heart failure self- management. Up to date Ministry of Health 2013.
[16]	Barrett M. Patient Self -Management Tools: An Overview. California Health Care Foundation 2005; 5-30.
[17]	Drawz PE, Goswami P, Azem R,Babineau DC, Rahman M.A Simple Tool to Predict ESRD Within 1 Year in Elderly Patients with Advanced CKD. J Am Geriatr Soc. 2013; 61(5): 762-768.
[18]	Donald M, Kahlon BK, Beanlands H, Straus S, Ronksley P, Herrington G, Tong A, Grill A, Waldvogel B, Large CA, Large CL, Harwood L, Novak M, James MT, Elliott M, Fernandez N, Brimble S, Samuel S, Hemmelgarn BR. Self-management interventions for adults with chronic kidney disease: a scoping review. BMJ Open 2018; 8: e019814.
[19]	Berns JS. Patient education: Chronic kidney disease (Beyond the Basics). UpToDate, Inc. 2019, available at: https://www.uptodate.com/contents/chronic-kidney-disease- beyond-the-basics retrieved in November 2019.
[20]	Tout DF, Boulware LE. Telehealth Applications to Enhance Chronic Kidney Disease Knowledge and Awareness among Patients and Providers. Adv Chronic Kidney Dis. 2017; 24(1): 39-45.
[21]	Dennison D, Golaszewski T. The Activated Health Education model: refinement and implications for school health education. J Sch Health. 2002; 72(1): 23-6.
[22]	World Health Organization. Regional Office for the Eastern Mediterranean. Health Education: Theoretical Concepts, Effective Strategies and Core Competencies, a Foundation Document to Guide Capacity Development of Health Educators. 2012 Available at: http://applications.emro.who.int/dsaf/EMRPUB_2012_EN_1362.p df Accessed in January 2020.
[23]	Parcel GS, Baranowski T. Social learning theory and health education. Health Educ. 1981; 12: 14-18.
[24]	Welch, J. L., Johnson, M., Zimmerman, L., Russell, C. L., Perkins, S. M., & Decker, B. S. Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review. Western Journal of Nursing Research, 2015; 37(5), 652-678.
[25]	Canadian Diabetes Association. Stages of CKD of all types 2019 available at: https://www.diabetes.ca/managing-my-diabetes/tools- --resources/stages-of-ckd-of-all-types Retrieved in January 2020.
[26]	Conceição A, Santos M, Santos B, Cruz D. Self-care in heart failure patients. Rev. Latino-Am. Enfermagem 2015; 23(4): 578-86.
[27]	Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017; 389(10075):1238-52.
[28]	Levin A, Tonelli M, Bonventre J, Coresh J, Donner JA, Fogo AB, Fox CS, Gansevoort RT, Heerspink HJL, Jardine M, Kasiske B, Köttgen A, Kretzler M, Levey AS, Luyckx VA, Mehta R, Moe O, Obrador G, Pannu N, Parikh CR, Perkovic V, Pollock C, Stenvinkel P, Tuttle KR, Wheeler DC, Eckardt KU. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017; 390(10105):1888-917.
[29]	Peng S, He J, Huang J, Lun L, Zeng J, Zeng S, La Zhang, Liu X, Wu Y. Self-management interventions for chronic kidney disease: a systematic review and meta-analysis. BMC Nephrology (2019) 20: 142.
[30]	Riegel, B., Carlson, B., Moser, D. K., Sebern, M., Hicks, F., & Roland, V. Psychometric testing of the self-care of heart failure index. Journal of Cardiac Failure 2004; 10(4), 350-360.
[31]	Fathi A. Effect of Role-Play versus Lecture Teaching Strategies on Nursing Students' Communication Skills during Patient Education. Unpublished P.hd Thesis. Alexandria: University of Alexandria, Faculty of Nursing 2011: 23-37.
[32]	Bonner A, Havas K, Douglas C, Thepha T, Bennett P, Clark R. Self-management programmes in stages 1-4 chronic kidney disease: a literature review. J Ren Care. 2014; 40(3):194-204.
[33]	Jones F, Riazi A. Self-efficacy and self-management after stroke: a systematic review. Disabil Rehabil. 2011; 33(10):797-810.
[34]	Fathi A, Tawfik F, Abudari M. Using a self-care management tool to improve self-care and quality of life in patients with congestive heart failure. Clinical Nursing Studies. 2016; 4(3) : 1-17.
[35]	Nguyen NT, Douglas C, Bonner A. Effectiveness of self-management programme in people with chronic kidney disease: A pragmatic randomized controlled trial. J Adv Nurs. 2019; 75(3): 652-664.
[36]	Meng K, et al. Evaluation of a self-management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation: study protocol of a cluster randomized controlled trial. Bio-Med Central Ltd Cardiovascular Disorders 2013, 13: 60. available at http://www.biomedcentral.com/1471-2261/13/60.
[37]	Curtin RB, Walters BAJ, Schatell D et al. Self-efficacy and self-management behaviors in patients with chronic kidney disease. Adv Chronic Kidney Dis 2008; 15: 191-205.
[38]	Lin CC, Wu CC, Anderson RM, Chang CS, Chang SC, Hwang SJ, Chen HC. The chronic kidney disease self-efficacy (CKD-SE) instrument: development and psychometric evaluation. Nephrol Dial Transplant 2012; 27: 3828-3834.
[39]	Padilla J, Krasnoff J, Da Silva M, Hsu CY, Frassetto L, Johansen KL, Painter P. Physical functioning in patients with chronic kidney disease. J Nephrol. 2008; 21(4): 550-9.
[40]	Carrero JJ, Yilmaz MI, Lindholm B, Stenvinkel P. Cytokine dysregulation in chronic kidney disease: how can we treat it? Blood Purif. 2008; 26(3): 291-9.
[41]	Zimbudzi E, Lo C, Kerr PG, Zoungas S. A need-based approach to self-management education for adults with co-morbid diabetes and chronic kidney disease. BMC Nephrology 2019; 20: 113. available at: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882- 019-1296-z retrieved in February 2020.
[42]	Rankin D, Heller S, Lawton J. Understanding information and education gaps among people with type 1 diabetes: a qualitative investigation. Patient Educ Couns. 2011; 83(1):87-91.
[43]	Havas K, Bonner A, Douglas C. Self-management support for people with chronic kidney disease: patient perspectives. J Ren Nutr. 2016; 42(1):7-14.
[44]	Elliott JA, Abdulhadi NN, Al-Maniri AA, Al-Shafaee MA, Wahlström R. Diabetes self-management and education of people living with diabetes: a survey in primary health Care in Muscat Oman. PLoS One. 2013; 8(2): e57400.
[45]	Lederer S, Fischer MJ, Gordon HS, Wadhwa A, Popli S, Gordon EJ. A question prompt sheet for adult patients with chronic kidney disease. BMC Nephrol. 2016; 17(1): 155.
[46]	Siabani S, Driscoll T, Davidson P, Leeder S. Efficacy of a home-based educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure in western Iran: A randomized controlled trial. The European Society of Cardiology 2015.
[47]	El-Metwaly A, Abd-El Razik B, Farouk A, Mohammed A. Effect of Teaching Guidelines on self-efficacy for Patients with End Stage Renal Disease Undergoing Hemodialysis. Port Said Scientific Journal of Nursing 2017; 4(2) 267-285.
[48]	Mersal FA, Aly RA. Effect of Patient Education on Coping, Quality of Life, Knowledge and Self Efficacy of Kidney Recipient Patients. American Journal of Nursing Science 2014; 3(5) 78-86.
[49]	Sorait W. The association of self-efficacy and self-management behavior in adult patients with chronic kidney disease: an integrative review. J Kidney Treat Diagn 2018; 1 (1).