Predictors of quality of life in Thai adults with early-stage chronic kidney disease
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The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Persons with CKD constitute a large population with a high prevalence of morbidity and mortality in Thailand. Treatment of CKD generally involves a multidisciplinary team and requires a comprehensive assessment and aggressive treatment plan to improve the health status of persons with CKD to slow the disease progression. This study aimed to examine factors that influence quality of life among Thai adults with early-stage CKD and test the constructs of a complex model identifying individual and family factors, knowledge, depression, and self-efficacy related to self-management behavior and quality of life.
Using a conceptual framework for adult self-management behavior based on the Individual and Family Self-management Behavior Theory (IFSMT), this study tested the constructs of this complex model, identifying individual and family factors, physical and social environment, condition-specific factors, and the process of self-management as predictors of both self-management behavior and quality of life. This cross-sectional study collected data between July and September 2018 including 622 Thai adults with CKD stage 1 to 3 from four hospitals in the south of Thailand. Statistical analyses were performed using structural equation modeling.
Results from the structural equation models found that the constructs of self management knowledge, self-efficacy, and self-management behavior accounted for significant variance in the prediction of quality of life in adults with early stages of CKD. These findings support the constructs of IFSMT as predictors of quality of life. Results of the multiple regression model found significant depression, diabetes, and family support indicator variables predicting self-efficacy and self-management knowledge. Self-efficacy was a mediator between self-management knowledge and self-management behaviors.
This study addressed a health promotion topic of critical concern to nurses working with adults with mild and moderate CKD in a variety of healthcare management settings. It utilized a complex and holistic approach to persons with CKD focusing on the identification of specific knowledge, self-management behavior and self-efficacy factors related to quality of life. The findings of this study could lead to the development of more appropriate policies, preventive education programs, screening methods and interventions that focus specifically on these factors in Thailand. The results can also inspire future research in this arena by nurse researchers interested in adults with early-stage CKD.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Cross-Sectional |
Research Approach | Quantitative Research |
Keywords | Chronic Kidney Disease; Thailand; Quality of Life; Adults; Self-Management |
Grantor | University of Massachusetts Lowell |
Advisor | Mawn, Barbara; Morris, Nancy; Corapi, Kristin; Chansatitporn, Natkamol |
Level | PhD |
Year | 2019 |
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