title: Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review.
abstract: The prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States. Knowledge gaps included the focus on medical self-management tasks with no attention to role or emotional tasks, lack of family involvement during intervention delivery, and an inability to form conclusions about the efficacy of interventions because methodological rigor was insufficient. Educational content varied across studies. Strategies to improve self-management skills and enhance self-efficacy varied and were limited in scope. Further development and testing of theory-based interventions are warranted. There is a critical need for future research using well-designed trials with appropriately powered sample sizes, well-tested instruments, and clear and consistent reporting of results.
authors.affiliation: Indiana University, Indianapolis, USA jwelch@iupui.edu.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Welch
authors.affiliation: University of Nebraska Medical Center, Lincoln, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Johnson
authors.affiliation: University of Nebraska Medical Center, Lincoln, USA.
authors.forename: Lani
authors.initials: L
authors.lastname: Zimmerman
authors.affiliation: University of Missouri-Kansas City, Kansas City, USA.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Russell
authors.affiliation: Indiana University, Indianapolis, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.affiliation: Indiana University, Indianapolis, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Decker
mesh_terms: D019468:Disease Management; D006801:Humans; D051437:Renal Insufficiency / Q000628:therapy*; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012648:Self Care / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States
keywords: chronic kidney disease; knowledge; renal insufficiency; self-efficacy; self-management