FACTORS INFLUENCING SELF-MANAGEMENT OF END-STAGE RENAL DISEASE (ESRD) PEOPLEUNDERGOING HEMODIALYSIS IN BHUTAN

Abstract

End stage renal disease [ESRD] is the last stage of chronic kidney disease [CKD] which is irreversible and permanent. ESRD has become a public health challenge worldwide due to increasing prevalence and burden on health sectors.This predictive study aimed to explore self-management and examine the predictive relationships of self-efficacy, social support, and health literacy towards self-management of Bhutanese ESRD patients undergoing hemodialysis. A sample of 81 ESRD patients undergoing hemodialysis at dialysis center of Jigme Dorji Wangchuk National Referral Hospital, Bhutan was recruited for this study using convenience sampling technique. Data were collected in March 2018 using a set of questionnaires and medical records. The set of questionnaires consisted of DDQ, IPAQ - SF,ESRD - AQ, SEMCD - 6 item scale, MSPSS, BHLS, and SLUMS questionnaire. Descriptive statistics, Pearson’s product correlations, and Standard multiple regressions were used to analyze data.

Findings of the study revealed that self-management of ESRD patients undergoing hemodialysis in Bhutan was at moderate level (2.17, SD = 0.61), and was positively associated with self-efficacy (r = .496, p < .01) and social support (r = .447, p < .01), but was not associated with health literacy (r = .116, p > .05). Regression analysis revealed that self-management was predicted by self-efficacy (β = .367, p < .01) and social support (β = .300, p < .05). Health literacy was not a significant predictor. The total variance explained was 32 % (R2 = .32, p < .001). Self-efficacy and social support play important role in self-management of ESRD patients undergoing hemodialysis. The findings of the study can be used to develop future self-management interventions for ESRD patients undergoing hemodialysis in Bhutan.

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