Promoting self-management improves the health status of patients having peritoneal dialysis.
OBJECTIVE
This paper is a report of a study conducted to explore the effects of promoting self-management on the well-being of patients having peritoneal dialysis.


BACKGROUND
Peritoneal dialysis is a home-based treatment for end-stage renal disease. Promoting self-management has been shown to improve the health status of people with diabetes mellitus and other chronic diseases. However, little is known about the effects of self-management support for patients having peritoneal dialysis.


METHODS
Thirty patients who had received peritoneal dialysis for at least 6 months and were clinically stable were enrolled in the study in 2006. A multidisciplinary team was built to support the patients' self-management. Various forms of education such as group discussion and individual consultation were used to improve patients' self-efficacy and all were followed up for 6 months. We compared the volume status, adequacy of dialysis, nutritional status, quality of life, rehabilitation status, self-management capacity and self-efficacy levels at baseline, 3 and 6 months after enrolment.


RESULTS
During follow-up, patients' urine volume and residual renal function decreased, while the adequacy of dialysis (Kt/v and Ccr) did not change. Volume status, quality of life and rehabilitation status all improved, whereas nutritional status did not deteriorate. Both self-management capacity and self-efficacy level increased statistically significantly.


CONCLUSIONS
A team approach needs to be taken to achieve successful self-management in patients having peritoneal dialysis, as with other chronic disease treatments. Nurses should use multiple strategies based on self-efficacy theory to improve patients' self-efficacy levels and self-management capacities.
Su
Chun-Yan
CY
Division of Nephrology, Peking University Third Hospital, Beijing, China.
Lu
Xin-Hong
XH
Chen
Wei
W
Wang
Tao
T
D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007676:Kidney Failure, Chronic / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010353:Patient Education as Topic; D010530:Peritoneal Dialysis; D011788:Quality of Life; D012648:Self Care / Q000592:standards*; D014556:Urine