Article

Effects of a Self-Management Skills-Acquisition Program on Pre-Dialysis Patients with Diabetic Nephropathy

Harada Hospital, Hiroshima, Japan.
Nephrology nursing journal: journal of the American Nephrology Nurses' Association (Impact Factor: 0.62). 06/2013; 40(2):141-8; quiz 149.
Source: PubMed

ABSTRACT

Kazawa, K., & Moriyama, M. (2013). Effects of a self-management skills-acquisition program on pre-dialysis patients with diabetic nephropathy. Nephrology Nursing Journal, 40(2), 141-148. The study was to examine the effects of a six-month educational program aiming acquisition of self management skills on patients with diabetic nephropathy. One-group, pre- and post-test design was performed. Face-to-face and telephone interviews were conducted by nurses. Thirty participants completed the program. As a result of the program, self efficacy, self management ability, and HbA1c improved; and renal function was maintained.

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Available from: Michiko Moriyama, Jan 26, 2015
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    • "Evidence concerning the beneficial effects of greater empowerment through education programs is inconclusive. While a Cochrane systematic review studying the effects of education programs in diabetes and CKD concluded that the evidence was poor[25], more recent studies have reported that education programs improve self-management , glycaemic control, and prevent kidney function decline[26,27]. Nevertheless, given studies showing the importance of patient empowerment and self-management in diabetes[28,29]or in CKD[30,31]and the emphasis that patients and their carers placed on the patient self-management and empowerment in our study, both factors should be considered central in a person-centred health system for co-morbid diabetes and CKD. Participants with co-morbid diabetes and CKD emphasised poor continuity and coordination of care as a barrier. "
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    ABSTRACT: Background: Multi-morbidity due to diabetes and chronic kidney disease (CKD) remains challenging for current health-systems, which focus on single diseases. As a first step toward health-care improvement, we explored the perspectives of patients and their carers on factors influencing the health-care of those with co-morbid diabetes and CKD. Methods: In this qualitative study participants with co-morbid diabetes and CKD were purposively recruited using maximal variation sampling from 4 major tertiary health-services from 2 of Australia's largest cities. Separate focus groups were conducted for patients with CKD stages 3, 4 and 5. Findings were triangulated with semi-structured interviews of carers of patients. Discussions were transcribed verbatim and thematically analysed. Results: Twelve focus groups with 58 participants and 8 semi-structured interviews of carers were conducted. Factors influencing health-care of co-morbid diabetes and CKD grouped into patient and health service level factors. Key patient level factors identified were patient self-management, socio-economic situation, and adverse experiences related to co-morbid diabetes and CKD and its treatment. Key health service level factors were prevention and awareness of co-morbid diabetes and CKD, poor continuity and coordination of care, patient and carer empowerment, access and poor recognition of psychological co-morbidity. Health-service level factors varied according to CKD stage with poor continuity and coordination of care and patient and carer empowerment emphasized by participants with CKD stage 4 and 5, and access and poor recognition of psychological co-morbidity emphasised by participants with CKD stage 5 and carers. Conclusions: According to patients and their carers the health-care of co-morbid diabetes and CKD may be improved via a preventive, patient-centred health-care model which promotes self-management and that has good access, continuity and coordination of care and identifies and manages psychological morbidity.
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "This service framework and program has been developed for the first time in Japan, in which health insurers entrust a disease management corporation to identify target populations based on data about medical claim and the results of health check-up examinations, after which the corporation approaches the patients and primary physicians . The completion rate was 79.3%, which is consistent with previous results [10]-[16]. Most of the dropouts withdrew from the program early because they were too busy or because they had already received education at a hospital, while few patients withdrew during the latter half of the program. "

    Full-text · Article · Jan 2015 · Health
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    • "This service framework and program has been developed for the first time in Japan, in which health insurers entrust a disease management corporation to identify target populations based on data about medical claim and the results of health check-up examinations, after which the corporation approaches the patients and primary physicians . The completion rate was 79.3%, which is consistent with previous results [10]-[16]. Most of the dropouts withdrew from the program early because they were too busy or because they had already received education at a hospital, while few patients withdrew during the latter half of the program. "

    Full-text · Article · Jan 2015 · Health
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