Factors Influencing Self-management of End-stage Renal Disease (ESRD) Patients Undergoing Hemodialysis in Bhutan

Abstract

Objective: To determine self-management and examine its predictive relationships with self-efficacy, social support, and health literacy in Bhutanese end-stage renal disease (ESRD) patients undergoing hemodialysis.Methods: A sample of 81 ESRD people undergoing hemodialysis at the dialysis center of Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) of Bhutan was recruited with the convenience sampling technique. Data were collected in March 2018 using a package of questionnaires and medical reviews sheet. The package of questionnaires consisted of demographic data, the International Physical Activity Questionnaire Short-Form, ESRD Adherence questionnaire, Self-efficacy for Managing Chronic Disease 6-Item Scale, Multidimensional Scale of Perceived Social Support, Brief Health Literacy Screen, and Saint Louis University Mental Status (SLUMS) examination questionnaire. Descriptive statistics, Pearson’s product moment correlations, and standard multiple regressions were used to analyze data. Results: Self-management of ESRD people undergoing hemodialysis in Bhutan was at a moderate level (2.17 ± 0.61). Self-management was significantly positively associated with self-efficacy (r = 0.496, P-value < 0.01) and social support (r = 0.447, P-value < 0.01), but not with health literacy (r = 0.116, P-value = 0.301). Regression analysis revealed that self-management was predicted by self- efficacy (b = 0.37, P-value < 0.001) and social support (b = 0.30, P-value < 0.05). The total variance of self-management explained was 32% (R2 = 0.320, P-value < 0.001). Conclusion: Self-efficacy and social support played an important role in self-management of ESRD patients undergoing hemodialysis. The findings of the study could be used to develop future self-management interventions for ESRD patients undergoing hemodialysis in Bhutan. Keywords: end-stage renal disease, ESRD, hemodialysis, self-management, predicting factors, self-efficacy, social support, health literacy