title: Patient activation with knowledge, self-management and confidence in chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease.
  
  
  OBJECTIVE
  This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease.
  
  
  METHODS
  The study employed a descriptive correlational design.
  
  
  METHODS
  Participants were recruited from five primary care, three nephrology clinics and one dialysis centre in two Midwestern cities in the United States.
  
  
  METHODS
  The convenience sample included 85 adults with hypertension, diabetes mellitus and chronic kidney disease, including kidney failure, who spoke English.
  
  
  METHODS
  Seven measurements were used to collect data via telephone interviews with participants not receiving haemodialysis, and face-to-face interviews with those receiving haemodialysis at the beginning of their treatment session.
  
  
  RESULTS
  Analyses indicated that half the participants were female (50.58%), the mean age was 63.21 years (SD = 13.11), and participants with chronic kidney disease stage 3 were the most activated. Post hoc differences were significant in patient activation and blood pressure self-management and anxiety across chronic kidney disease stages, excluding stage 5.
  
  
  CONCLUSIONS
  Engaging patients in the self-management of their health care and enhancing patients' ability to self-manage their blood pressure may work to preserve kidney health. Healthcare providers should collaborate with patients to develop strategies that will maintain patients' health-related quality of life, like reducing anxiety as kidney disease progress.
authors.affiliation: Bryan College of Health Sciences, Lincoln, Nebraska, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Johnson
authors.affiliation: University of Nebraska Medical Center, Lincoln, Nebraska, USA.
authors.forename: Lani
authors.initials: L
authors.lastname: Zimmerman
authors.affiliation: Indiana University School of Nursing, Indianapolis, Indiana, USA.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Welch
authors.affiliation: University of Nebraska Medical Center, Lincoln, Nebraska, USA.
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.affiliation: University of Nebraska Medical Center, Lincoln, Nebraska, USA.
authors.forename: Bunny
authors.initials: B
authors.lastname: Pozehl
authors.affiliation: University of Nebraska Medical Center, Nephrology, Omaha, Nebraska, USA.
authors.forename: Troy
authors.initials: T
authors.lastname: Plumb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012648:Self Care; D012649:Self Concept; D014481:United States
keywords: Chronic kidney disease; Health-related quality of life; Patient activation; Self-management