A need-based approach to self-management education for adults with co-morbid diabetes and chronic kidney disease

BMC Nephrol. 2019 Apr 2;20(1):113. doi: 10.1186/s12882-019-1296-z.

Abstract

Background: Self-management education needs have not been assessed in patients with complex co-morbid conditions such as diabetes and chronic kidney disease (CKD). The objectives of this study were to 1) determine the self-management education needs for patients with co-morbid diabetes and CKD and 2) co-develop an educational resource meeting the self-management education needs of patients with co-morbid diabetes and CKD.

Methods: Patients with co-morbid diabetes and CKD attending a co-designed, patient-centred outpatient diabetes and kidney clinic at a tertiary metropolitan hospital were recruited for semi-structured interviews. Maximal variation sampling was used, ensuring adequate representation of different gender, age, diabetes duration and stage of CKD. Data were thematically analysed using grounded theory.

Results: Forty-two patients participated. Most were male (67%) and the mean age was 64.8 (11.1) years. The majority of patients preferred an educational resource in the form of a Digital Versatile Disc (DVD) and they thought that current education could be improved. In particular patients wanted further education on 1) management of diabetes and kidney disease (including nutrition and lifestyle, and prevention of the progression of kidney disease) and 2) complications of comorbid diabetes and kidney disease.

Conclusion: Patients with co-morbid diabetes and kidney disease have education gaps on the management of, and complications of diabetes and kidney disease. Interventions aimed at improving patient education need to be delivered through education resources co-developed by patients and health staff. A targeted education resource in the form of a DVD, addressing these needs, may potentially close these gaps.

Keywords: Chronic kidney disease, self-management education; Diabetes; Patient engagement; Patient-centred care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Comorbidity
  • Diabetes Complications / epidemiology*
  • Diabetes Mellitus / epidemiology*
  • Female
  • Focus Groups
  • Grounded Theory
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Patient Education as Topic / methods*
  • Patient Preference / statistics & numerical data
  • Qualitative Research
  • Renal Insufficiency, Chronic / epidemiology*
  • Resource Allocation
  • Self Care* / methods
  • Self Care* / psychology
  • Self-Management / education*