Activation of Patient Undergoing Hemodialysis and its relationship with self-efficacy in patients referring to Hemodialysis Unit of Emam Reza Medical Research and Training Hospital, Tabriz, 2020

Abstract

Abstract

Background and aim: One of the concepts that is emphasized recently in the care of chronic diseases such as chronic kidney disease is the activeness of the patient in managing his health, which is called patient activation. Patient activation is an important criterion in measuring the quality of care, which can have positive consequences for patients.Given the importance of patients' activation in improving the quality of chronic disease care, this study aimed to assess patients' activation levels and its relationship with self-efficacy among patients undergoing hemodialysis. Methods: In this cross-sectional study, a total of 180 patients undergoing maintenance hemodialysis were selected by convenience sampling from the hemodialysis center of Emam Reza hospital, Tabriz, Iran. Data were collected by demographics, patient activation measure, and chronic kidney disease self-efficacy (CKD-SE) scale from March to May 2021. Collected data were analyzed using SPSS software (ver. 26) using ANOVA, t-test, Pearson correlation coefficient, and multiple regression tests. Results: The majority of the participants (35%) were at level 1 of activation and only 28.9% of the individuals were at level 4. According to the results, the mean score of self-efficacy in patients undergoing hemodialysis (in a possible range of 0 to 10) was 5.50±1.45. Multiple regression analysis showed that factors including self-efficacy, educational level, and marital status were significant predictors of change in patient activation (R2=.85, adjusted R2=.66, p<.001). The results showed that self-efficacy was the main predictor of patient activation (β =0.49, p<.001). Conclusion: According to the result, improving the patients' self efficacy could improve the patient's activation. Therefore, healthcare providers, especially nurses working in dialysis units, should empover hemodialysis patients to be more active in their health management by providing the necessary training and involving patients in clinical decision-making and improving their health literacy level. It is suggested to periodically measure and monitor the level of patients' activation and provide training according to the level of activation. Furthermore, measuring patients' activation level at admission to the dialysis unit is recommended for all patients undergoing hemodialysis.