title: Factors associated with self-management by people undergoing hemodialysis: a descriptive study.
abstract: BACKGROUND
  Improving the level of self-management by people undergoing hemodialysis is an effective way to reduce the incidence of mortality and complications and improve quality of life. A better understanding of what influences an individual's level of self-management can help nurses find appropriate ways to improve self-management.
  
  
  OBJECTIVE
  To examine self-management levels, and discuss the factors influencing self-management, in a sample of patients undergoing hemodialysis in Beijing.
  
  
  METHODS
  A descriptive study design was chosen.
  
  
  METHODS
  A convenience sample of 216 patients undergoing hemodialysis was recruited from dialysis centers in three tertiary hospitals in Beijing from September 2010 to January 2011. Questionnaires were used to examine the variables: level of self-management; knowledge of hemodialysis; self-efficacy; anxiety and depression; and social support. Data analysis involved descriptive statistics, including frequency, percentage, mean and standard deviations, while Spearman correlation, non-parametric Z and χ(2) and multiple linear regression were used for comparative purposes.
  
  
  RESULTS
  The number of returned questionnaires was 198 (91.67% response rate). The overall score of self-management was 56.01 (SD=10.75). The average item scores for each of the four self-management subscales were 3.02 for partnership, 2.98 for problem-solving skills, 2.74 for self-care and 2.47 for emotional management. Multiple linear regression analyses for overall self-management and the four subscales indicated that knowledge, self-efficacy, the availability of social support and depression were the main influencing factors which explained 34.1% of the variance of self-management.
  
  
  CONCLUSIONS
  The level of self-management by those undergoing hemodialysis in this study was less than ideal, varying from 'rare' to 'sometimes' for use of self-management behaviors. For the different subscales of self-management, partnership was the most used and emotional management the least used strategy. Patients' knowledge, self-efficacy, the availability of social support and depression were the main factors influencing self-management.
authors.affiliation: International Medical Service, Peking Union Medical College Hospital, 1 Shuaifuyuan Wangfujing, Beijing 100730, China. Electronic address: kathy-lee2004@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: School of Nursing, Peking Union Medical College, Beijing, China. Electronic address: jiangyfpumc@gmail.com.
authors.forename: Ya-Fang
authors.initials: YF
authors.lastname: Jiang
authors.affiliation: School of Nursing, Kaohsiung Medical University, Taiwan.
authors.forename: Chiu-Chu
authors.initials: CC
authors.lastname: Lin
mesh_terms: D002681:China; D006801:Humans; D006435:Renal Dialysis; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: End Stage Renal Disease; Hemodialysis; Self-efficacy; Self-management