Promoting self‐management improves the health status of patients having peritoneal dialysis

Abstract Title. Promoting self‐management improves the health status of patients having peritoneal dialysis. Aim. This paper is a report of a study conducted to explore the effects of promoting self‐management on the well‐being of patients having peritoneal dialysis. Background. Peritoneal dialysis is a home‐based treatment for end‐stage renal disease. Promoting self‐management has been shown to improve the health status of people with diabetes mellitus and other chronic diseases. However, little is known about the effects of self‐management support for patients having peritoneal dialysis. Method. Thirty patients who had received peritoneal dialysis for at least 6 months and were clinically stable were enrolled in the study in 2006. A multidisciplinary team was built to support the patients’ self‐management. Various forms of education such as group discussion and individual consultation were used to improve patients’ self‐efficacy and all were followed up for 6 months. We compared the volume status, adequacy of dialysis, nutritional status, quality of life, rehabilitation status, self‐management capacity and self‐efficacy levels at baseline, 3 and 6 months after enrolment. Results. During follow‐up, patients’ urine volume and residual renal function decreased, while the adequacy of dialysis (Kt/v and Ccr) did not change. Volume status, quality of life and rehabilitation status all improved, whereas nutritional status did not deteriorate. Both self‐management capacity and self‐efficacy level increased statistically significantly. Conclusion. A team approach needs to be taken to achieve successful self‐management in patients having peritoneal dialysis, as with other chronic disease treatments. Nurses should use multiple strategies based on self‐efficacy theory to improve patients’ self‐efficacy levels and self‐management capacities.