Pre-dialysis patients' perceived autonomy, self-esteem and labor participation: associations with illness perceptions and treatment perceptions. A cross-sectional study.
BACKGROUND
Compared to healthy people, patients with chronic kidney disease (CKD) participate less in paid jobs and social activities. The aim of the study was to examine a) the perceived autonomy, self-esteem and labor participation of patients in the pre-dialysis phase, b) pre-dialysis patients' illness perceptions and treatment perceptions, and c) the association of these perceptions with autonomy, self-esteem and labor participation.


METHODS
Patients (N = 109) completed questionnaires at home. Data were analysed using bivariate and multivariate analyses.


RESULTS
The results showed that the average autonomy levels were not very high, but the average level of self-esteem was rather high, and that drop out of the labor market already occurs during the pre-dialysis phase. Positive illness and treatment beliefs were associated with higher autonomy and self-esteem levels, but not with employment. Multiple regression analyses revealed that illness and treatment perceptions explained a substantial amount of variance in autonomy (17%) and self-esteem (26%). The perception of less treatment disruption was an important predictor.


CONCLUSIONS
Patient education on possibilities to combine CKD and its treatment with activities, including paid work, might stimulate positive (realistic) beliefs and prevent or challenge negative beliefs. Interventions focusing on these aspects may assist patients to adjust to CKD, and ultimately prevent unnecessary drop out of the labor market.
NIVEL, Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands. d.jansen@nivel.nl
Daphne L
DL
Jansen
Diana C
DC
Grootendorst
Mieke
M
Rijken
Monique
M
Heijmans
Ad A
AA
Kaptein
Elisabeth W
EW
Boeschoten
Friedo W
FW
Dekker
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D026684:Personal Autonomy; D006435:Renal Dialysis / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult