title: Self-management programmes in stages 1-4 chronic kidney disease: a literature review.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a complex health problem, which requires individuals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens.
  
  
  OBJECTIVE
  To review studies delivering self-management interventions to people with CKD (Stages 1-4) and assess whether these interventions improve patient outcomes.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013.
  
  
  RESULTS
  The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures.
  
  
  CONCLUSIONS
  The effectiveness of self-management programmes in CKD (Stages 1-4) cannot be conclusively ascertained, and further research is required. It is desirable that individuals with CKD are supported to effectively self-manage day-to-day aspects of their health.
authors.affiliation: School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia; CKD.QLD and Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Bonner
authors.forename: Kathryn
authors.initials: K
authors.lastname: Havas
authors.forename: Clint
authors.initials: C
authors.lastname: Douglas
authors.forename: Thiwawan
authors.initials: T
authors.lastname: Thepha
authors.forename: Paul
authors.initials: P
authors.lastname: Bennett
authors.forename: Robyn
authors.initials: R
authors.lastname: Clark
mesh_terms: D000328:Adult; D005919:Glomerular Filtration Rate; D057220:Health Literacy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000451:nursing* / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D017582:Renal Replacement Therapy / Q000451:nursing* / Q000523:psychology*; D012648:Self Care / Q000523:psychology*
keywords: Chronic kidney disease; Education; Self-care; Self-management