Predictors of Self-Management Behaviors After Discharge Among Unplanned Dialysis Patients

J Nurs Res. 2023 Apr 1;31(2):e267. doi: 10.1097/jnr.0000000000000523.

Abstract

Background: Patients with unplanned dialysis must perform self-management behaviors to maintain their health in the community after discharge. Understanding the factors that predict the postdischarge self-management behaviors of patients with unplanned dialysis can assist nurses to implement appropriate discharge plans for this population.

Purpose: This study was designed to predict the effects of uncertainty in illness, self-care knowledge, and social-support-related needs during hospitalization on the self-management behaviors of patients with unplanned dialysis during their first 3 months after discharge from the hospital.

Methods: One hundred sixty-nine patients with unplanned dialysis from the nephrology department of a medical center in Taiwan were enrolled in this prospective study using convenience sampling. At hospital admission, demographic, uncertainty in illness, self-care knowledge, and social support information was collected using a structured questionnaire. Information on self-management behavior was collected at 3 months postdischarge when the patients visited outpatient clinics.

Results: Hierarchical multiple regression analyses showed that self-care knowledge, uncertainty in illness, and social support were important predictors of self-management behaviors at 3 months postdischarge, explaining 65.6% of the total variance in self-management behaviors. Social support increased the variance in self-management behaviors by 27.9%.

Conclusions/implications for practice: Comprehensive discharge planning to improve the postdischarge self-management behaviors of patients with unplanned dialysis should involve interventions to improve self-care knowledge, reduce uncertainty in illness, and increase social support. Building social support should be given priority attention.

MeSH terms

  • Aged
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge
  • Prospective Studies
  • Regression Analysis
  • Renal Dialysis* / nursing
  • Self-Management* / psychology
  • Social Support
  • Surveys and Questionnaires
  • Taiwan