The Impact of Illness Perceptions on Self-Management Behaviors in Chronic Kidney Disease Patients: A Randomized Controlled Trial

Aim: Effective self-management is essential for managing chronic kidney disease (CKD) and can enhance patients’ functioning and wellbeing. This study aims to examine the relationship between illness perceptions and self-management behaviors of CKD patients, as to whether illness perceptions are associated with improvements in self-management behaviors over time. Method: A randomized controlled trial was conducted to test an online self-management program with 121 participants, the majority of whom had received a kidney transplant (65.3%). Illness perceptions (helplessness, acceptance, emotional response, timeline and perceived control) were assessed using the ICQ and B-IPQ. Baseline self-management behaviors (medication adherence, healthy diet, physical activity, weight maintenance, and non-smoking) were measured with the PPPQ-self-management and the reported improvements or deterioration with regard to patients self-selected self-management goals with the PPPQ-self-management...Show moreAim: Effective self-management is essential for managing chronic kidney disease (CKD) and can enhance patients’ functioning and wellbeing. This study aims to examine the relationship between illness perceptions and self-management behaviors of CKD patients, as to whether illness perceptions are associated with improvements in self-management behaviors over time. Method: A randomized controlled trial was conducted to test an online self-management program with 121 participants, the majority of whom had received a kidney transplant (65.3%). Illness perceptions (helplessness, acceptance, emotional response, timeline and perceived control) were assessed using the ICQ and B-IPQ. Baseline self-management behaviors (medication adherence, healthy diet, physical activity, weight maintenance, and non-smoking) were measured with the PPPQ-self-management and the reported improvements or deterioration with regard to patients self-selected self-management goals with the PPPQ-self-management improvements at 6-months follow-up. Regression analyses were performed to examine the relationship between illness perceptions and self-management behaviors at baseline, as well as between illness perceptions at baseline and the reported improvements in self-management goals at 6-months follow-up. Analysis were controlled for the confounding variables gender, comorbidities, kidney transplantation, and participation in the E-GOAL study. Results: Helplessness showed a significant relationship with the reported self-management improvements at 6-months follow-up (R2= .040, β = -.20, p = .036), which remained significant after controlling for confounders. Patients who experienced greater helplessness at baseline reported smaller improvements in their self-management goals at 6- months follow-up. Conclusion: Helplessness was found to be significantly related to self- management improvements, yet no other significant relationships were found between the other illness perceptions and the self-management behaviors or their improvements in CKD patients. These findings suggest that addressing feelings of helplessness in self-management programs may be crucial, as it can interfere with self-management improvements. Healthcare providers could assess patients’ levels of helplessness and incorporate psychological interventions into self-management programs to reduce these feelings and support patients in improving their self-management behaviors, ultimately leading to better overall patient wellbeing.Show less

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The Impact of Illness Perceptions on Self-Management Behaviors in Chronic Kidney Disease Patients: A Randomized Controlled Trial