Post on 27-Dec-2019
15/12/17
1
Queensland University of Technology
The missing piece: Self-management support desires of patients with CKD
Kathryn Havas1,2, Clint Douglas1, & Ann Bonner 1,2
1Queensland University of Technology, Brisbane, Australia2Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia
Adapted from National Research Corporation, 2015
Havas, Bonner & Douglas. 2016. Journal of Renal Care
Self-management support for people with chronic kidney disease: Patient Perspectives
1. Disease-specific knowledge2. Establishing routine and planning ahead3. Actively participating in healthcare4. Developing and sustaining a positive attitude and caring for
mental and physical wellbeing5. Modifying lifestyle6. Managing medications7. Recognising and effectively responding to symptoms8. Maintaining social and occupational roles9. Engaging and sustaining social support10.Building and sustaining effective relationships with HCPs
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18-245%
25-3916%
40-5929%
60-7943%
80+ 7%
AgeMale40%
Female60%
Gender N = 97
11% 14% 16% 10%
49%
0%20%40%60%80%
100%
≤12 Months
>1≤3 Years
>3≤5 Years
>5<10 Years
≥10 Years
Time since Diagnosed
Unemployed, 7%Casual,
3%
Part time, 22%
Full time, 23%
Retired, 40%
Other (Employed),
5%
Employment1%
14%27%
4%
30%18%
5% 1%0%
20%40%60%80%
100% Level of Education
<$20,00010%
$20,000-$39,999
40%
$40,000-$59,9998%
$60,000-$79,9997%
$80,000-$99,9992%
$100,000-$119,999
8%
$120,000+16%
Unreported9%
Annual Household Income
98 8 8
10
8 89 9
0123456789
10
Desire for Additional Support
59.38 59.0260.64
55.34 56.15 53.48
38.8435.32 36.1 35.47
42.28 42.04
0
10
20
30
40
50
60
70
Age(a) Ed(b) Employ(c) Income(d) Time(e) Gender(f)
Desire for Additional Support
* ** * ~
* p < .05~ p = .05a <60 vs 60+; b >10 years vs ≤10 years; c Employed vs Not Working; d >$40,000 vs <$39,999; e ≥10 years vs <10 years; f Female vs Male
*
Delivery Preferences
• Overall, most (72.2%) would attend SMS sessions during business hours• 100% of unemployed• 47.1% of employed
• Most happy with clinic environment (41.7%) or no preference (45.8%)
• About half (48.5%) open to individual/group/mix• 24.7% group• 26.8% individual
• Approximately half (49.5%) would like to bring support
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57.7%
70.1%
52.6%
71.1%
45.4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
GP Nephrologist Nurse SM Expert No Pref
Educator Preferences Additional Suggestions
• Only 10 participants identified online & smartphone tools as potentially helpful
• Hard copy materials (3 participants)• Accessibility for rural patients (2 participants)• Importance of educator being a good communicator (2
participants)• Individualised (2 participants)• Other suggestions:
• Videos• Telephone sessions• Program through hospital• Early in disease process
Implications
• Self-management complex & multifaceted• Not give information and instructions à patients “comply”
• Receivers vs. engagers• Different/more intensive strategies may be needed for receivers
• Need to empower patients early in disease process to effect change
• Multi-modal learning formats• Face-to-face, phone, written, internet
• Preferences for nephrologist or self-management expert to deliver
Person-Centred Care
What do people want?
To inform design of programs
Implementation of interpretation of what people
want
How did we do?
Evaluation of programs