EFFECTIVENESS OF NURSE-LED SELF-MANAGEMENT SUPPORT ON HEALTH-RELATED QUALITY OF LIFE AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE
DOI:
https://doi.org/10.29121/JISSI.v2.i1.2026.84Keywords:
Chronic Kidney Disease, Nurse-led Intervention, Self-Management, Health-Related Quality of Life, SF-36, Blood Pressure, Renal Function, eGFRAbstract
Background: Chronic Kidney Disease (CKD) is a progressive and irreversible disorder associated with significant morbidity, reduced quality of life and increased healthcare burden. Effective self-management strategies have been recommended to improve patients' health-related quality of life (HRQoL), treatment adherence and clinical outcomes. Nurse-led interventions have emerged as an important approach to empower patients with CKD through education, behavioural modification and continuous support.
Objectives: The present study aimed to evaluate the effectiveness of a nurse-led self-management programme on health-related quality of life and selected clinical outcomes among patients with Chronic Kidney Disease.
Methods: A quasi-experimental study with a pre-test and post-test control group design was conducted among 60 patients diagnosed with CKD. Participants were allocated into an intervention group (n = 30) and a control group (n = 30). Baseline demographic and clinical data were collected prior to the intervention. The intervention group received a structured nurse-led self-management programme, while the control group received routine clinical care. Health-related quality of life was assessed using the Short Form-36 (SF-36) questionnaire, while clinical outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), estimated glomerular filtration rate (eGFR), serum calcium and serum potassium levels. Data were analysed using descriptive statistics, independent sample t-test, paired t-test, Pearson correlation, multiple linear regression and analysis of covariance (ANCOVA).
Results: Baseline demographic and clinical characteristics were comparable between the intervention and control groups (p > 0.05). Following the intervention, the intervention group demonstrated statistically significant improvements in SF-36 physical and mental component scores compared with baseline (p < 0.001). Significant reductions were also observed in systolic and diastolic blood pressure, while renal function indicators, including eGFR and serum calcium, showed improvement following the intervention. Serum potassium levels demonstrated a significant reduction toward normal values. In contrast, the control group exhibited only minimal, statistically non-significant changes across most outcome measures (p > 0.05). Between-group comparison revealed significantly higher HRQoL scores and more favourable clinical outcomes in the intervention group than in the control group (p < 0.001). Pearson correlation analysis demonstrated significant positive associations between HRQoL and renal function, whereas blood pressure showed negative correlations with quality-of-life scores. Multiple linear regression identified eGFR and systolic blood pressure as significant predictors of physical quality of life. ANCOVA further confirmed that the intervention remained significantly effective after adjustment for baseline differences.
Conclusion: The findings suggest that the nurse-led self-management programme was effective in improving health-related quality of life and selected clinical outcomes among patients with Chronic Kidney Disease. Structured educational and behavioural interventions delivered by nurses may contribute to better disease management, improved patient empowerment, enhanced renal health and reduced cardiovascular risk. Integration of nurse-led self-management programmes into routine nephrology care may improve long-term patient outcomes and quality of life.
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