The Roles of Social Support and Health Literacy in Self-Management Among Patients With Chronic Kidney Disease

Yu-Chi Chen; Li-Chun Chang; Chieh-Yu Liu; Ya-Fang Ho; Shuo-Chun Weng; Tzu-I Tsai

doi:10.1111/jnu.12377

The Roles of Social Support and Health Literacy in Self-Management Among Patients With Chronic Kidney Disease

J Nurs Scholarsh. 2018 May;50(3):265-275. doi: 10.1111/jnu.12377. Epub 2018 Mar 23.

Authors

Yu-Chi Chen¹, Li-Chun Chang², Chieh-Yu Liu³, Ya-Fang Ho⁴, Shuo-Chun Weng⁵, Tzu-I Tsai⁶

Affiliations

¹ Lambda Beta-at-Large, Associate Professor, Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC.
² Lambda Beta-at-Large, Associate Professor, School of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan, ROC.
³ Associate Professor, Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan, ROC.
⁴ Lambda Beta-at-Large, PhD Candidate, Department of Nursing, School of Nursing, National Yang-Ming University, Taiwan, ROC.
⁵ PhD Candidate, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, and Attending Physician, Center for Geriatrics and Gerontology, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
⁶ Professor, Department of Nursing, School of Nursing, National Yang-Ming University, Taiwan, ROC.

PMID: 29569423
DOI: 10.1111/jnu.12377

Abstract

Aims: To investigate the relationships among social support, health literacy, and self-management, and the factors influencing self-management of chronic kidney disease (CKD).

Design: Cross-sectional study.

Methods: A random sample of 410 patients was recruited from nephrology clinics. Data were collected using structured questionnaires and chart reviews from January 2013 to February 2014. Hierarchical regression analysis was used to determine the predictive factors of self-management behaviors and ∆R² to determine each variable's explanatory power.

Findings: Health literacy and social support were positively correlated with self-management behaviors. Furthermore, social support, health literacy, and marital status were significant predictors of self-management behaviors. Social support had a relatively greater explanatory power for self-management behaviors than did health literacy. Particularly, healthcare provider support had the greatest influence on patients' self-management behaviors.

Conclusions: Health literacy and social support play independent positive roles in self-management behaviors of patients with CKD, with social support having a particularly dominant role. Further research using a systems approach to improving self-management behaviors is necessary to clarify the role of social support.

Clinical relevance: Health literacy and social support are independently and positively related to self-management. Social support, which is a system-level factor, is a relatively stronger and crucial predictor than is health literacy. Nurses have to refine self-management programs to focus on families and adopt a systems approach to help CKD patients improve their self-management behaviors.

Keywords: Chronic kidney disease; health literacy; nursing; self-management; social support.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Female
Health Literacy* / statistics & numerical data
Humans
Male
Marital Status
Regression Analysis
Renal Insufficiency, Chronic / psychology
Renal Insufficiency, Chronic / therapy*
Self Care / standards
Self-Management*
Social Support*
Surveys and Questionnaires