The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

Eunji Cha; Hyojung Park

doi:10.7469/kjan.2015.27.5.505

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Cha and Park: The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

Original Article

Korean J Adult Nurs 2015;27(5):505-514.

Published online: October 2015

DOI: https://doi.org/10.7469/kjan.2015.27.5.505

The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

Eunji Cha¹, Hyojung Park^2,

^¹Ewha Womans University Mokdong Hospital, Seoul

^²Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Park, Hyojung Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-2824, Fax: +82-2-3277-2850, E-mail: hyojungp@ewha.ac.kr

Received 3 June 20152 October 2015 Accepted 5 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to examine their levels of knowledge of the kidney, self-efficacy, and kidney function in pre-dialysis patients with chronic renal insufficiency.

Methods

A total of 142 pre-dialysis patients with chronic renal insufficiency were recruited from a nephrology clinic of a hospital in Korea. Participants knowledge of the kidney, self-efficacy, and kidney function were measured, and the correlations between these factors were computed.

Results

The levels of knowledge of the kidney were moderate, with a mean score of 12.30±5.35. Knowledge level was significantly correlated with age, education level, occupation, income, physical symptoms, and information resources (p<.05). The mean score for self-efficacy was 6.06±2.00. Self-efficacy was significantly associated with patients age, education level, occupation, income, cigarette use, and information resources (p<.05). The mean score for kidney function was 35.66±18.68 mL/min/1.73 m². Kidney function was significantly correlated with use of medications and drinking behavior (p<.05). Knowledge of the kidney was significantly correlated with self-efficacy (r=.31, p<.001), but not with kidney function. There was a significant correlation between self-efficacy and kidney function (r=.30, p<.001). Multiple regression analysis revealed that self-efficacy and drinking behavior accounted for 11% of the variance in kidney function of pre-dialysis patients with chronic renal insufficiency.

Conclusion

Nursing interventions are necessary to increase self-efficacy among pre-dialysis patients with chronic renal insufficiency in order to maintain their kidney function.

Keywords: Chronic renal insufficiency, Glomerular filtration rate, Knowledge, Self efficacy

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Table 1.

Demographic Characteristics of the Participants (N=142)

Characteristics	Categories	n (%) or M±SD
Age (year)		60.50±14.42
	＜40	13 (9.2)
	40~60	50 (35.2)
	＞60	79 (55.6)
Gender	Male	87 (61.3)
Gender	Female	55 (38.7)
Education	Uneducated	6 (4.2)
	Elementary school	20 (14.1)
	Middle school	19 (13.4)
	High school	48 (33.8)
	College	43 (30.3)
	Graduate school	6 (4.2)
Occupation	No	82 (57.7)
Occupation	Yes	60 (42.3)
Monthly income	None	17 (12.0)
	Less than $1,000	55 (38.7)
	$1,000~$2,000	20 (14.1)
	$2,000~$3,000	22 (15.5)
	More than $3,000	28 (19.7)
Symptom related to chronic renal insufficiency	No	89 (62.7)
	Yes	53 (37.3)

Medication^†	HTN	109 (77.3)
	DM	53 (37.6)
	Hyperlipidemia	49 (34.8)
	Diuretic	14 (9.9)
	Antithrombosis	12 (8.5)
Smoking	None	78 (54.9)
	Previous smoking	41 (28.9)
	Current smoking	23 (16.2)
Drinking behavior	No	100 (70.4)
Drinking behavior	Yes	42 (29.6)
Information	No	93 (65.5)
	Yes	49 (34.5)

DM=diabetes mellitus, HTN=hypertension;

^† Multiple response.

Table 2.

Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

Items	M±SD	n (%)	Range
Knowledge of the kidney	12.30±5.35		0~22
Self-efficacy	6.06±2.00		1~10
Communication with medical professional	6.71±2.70
Depression control	6.65±2.51
House work	6.64±2.67
Getting help from community, family, or friends	6.34±2.47
Symptom management	5.65±2.44
Regular exercise	5.56±2.44
General disease management	5.54±2.38
Collection of disease related information	4.86±3.10
Kidney function	35.66±18.68
Stage 1		1 (0.7)
Stage 2		17 (12.0)
Stage 3		61 (43.0)
Stage 4		44 (31.0)
Stage 5		19 (13.4)

Table 3.

Difference among the Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

Variables	Categories	n (%)	Knowledge of the kidney		Self-efficacy		Kidney function
Variables	Categories	n (%)	M±SD	t or F (p) LSD	M±SD	t or F (p) LSD	M±SD	t or F (p) LSD
Age (year)	＜40^a	13 (9.2)	14.77±1.38	11.09	7.14±0.54	5.49	43.43±5.14	2.19
	40~60^b	50 (35.2)	14.44±0.71	(＜.001)	6.50±0.27	(.005)	37.69±2.62	(.116)
	＞60^c	79 (55.6)	10.53±0.56	a, b＞c	5.61±0.22	a, b＞c	33.11±2.09
Education	≤Middle schooll^a	45 (31.7)	10.67±5.67	5.26	5.10±0.28	8.94	23.88±7.57	2.14
	High school^b	48 (33.8)	11.98±5.09	(.006)	6.32±0.27	(＜.001)	37.76±1.99	(.122)
	≥College^c	49 (34.5)	14.10±4.84	a＜c	6.69±0.27	a＜b, c	33.38±2.65
Occupation	Yes	60 (42.3)	14.28±0.66	15.85	6.64±0.25	9.24	33.48±3.64	2.68
Occupation	No	82 (57.7)	10.84±0.56	(＜.001)	5.64±0.21	(.003)	38.64±2.40	(.104)
Monthly income	None	17 (12.0)	12.41±1.27	4.20	6.29±0.46	8.08	37.08±4.56	0.07
	＜$2,000	75 (52.8)	11.17±0.60	(.017)	5.48±0.22	(＜.001)	35.25±2.17	(.935)
	＞$2,000	50 (35.2)	13.94±0.74		6.87±0.27		35.78±2.66
Periods of diagnosis (year)	＜1	42 (29.6)	12.05±0.83	0.18	5.97±0.31	2.57	36.08±2.88	1.05
	1~5	53 (37.3)	12.15±0.74	(.832)	5.69±0.27	(.080)	32.95±2.57	(.353)
	≥5	47 (33.1)	12.67±0.79		6.57±0.29		38.34±2.72
Smoking	Currently smoking	23 (16.2)	12.26±1.12	0.12	4.81±0.40	6.33	34.55±3.90	0.93
	Currently non-smoking	41 (28.9)	12.63±0.84	(.888)	6.55±0.30	(.002)	39.01±2.92	(.398)
	Non-smoking	78 (54.9)	12.13±0.61		6.18±0.22		34.22±2.12
Drinking behavior	Yes	100 (29.6)	13.14±0.82	1.50	6.27±0.31	0.60	41.05±2.84	5.10
Drinking behavior	No	42 (70.4)	11.94±0.53	(.223)	5.98±0.20	(.441)	33.40±1.84	(.025)
Symptom	Yes	53 (37.3)	14.40±0.70	14.26	5.99±0.28	0.12	37.61±2.57	0.92
Symptom	No	89 (62.7)	11.05±0.54	(＜.001)	6.11±0.21	(.727)	34.50±1.98	(.338)
Medication	Yes	125 (88.0)	12.30±0.48	0.00	5.97±0.18	2.23	33.99±1.63	8.83
Medication	No	17 (12.0)	12.29±1.30	(.988)	6.74±0.48	(.138)	47.96±4.41	(.003)
Resources	None^a	94 (66.2)	11.33±0.53	5.55	5.64±0.20	5.37	36.61±1.94	0.38
	Health care provider^b	27 (19.0)	13.07±0.98	(＜.001)	7.08±0.37	(.002)	32.23±3.62	(.767)
	Multimedia^c	13 (9.2)	13.92±1.42	a＜d	6.20±0.53	a＜b, d	35.69±5.21
	Both^d	8 (5.6)	18.38±1.80		7.37±0.68		35.90±6.65

Table 4.

Relationships among Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

Variables	Knowledge of the kidney	Self-efficacy
Variables	r (p)	r (p)
Self-efficacy	.31 (＜.001)
Kidney function	.07 (.424)	.30 (＜.001)

Table 5.

Influencing Factors on the Kidney Function

Variables	B	SE	_β	t	p	Tolerance	VIF
(Constant)	10.39	6.17		1.69	.094
Drinking behavior	6.88	3.26	.17	2.11	.036	0.99	1.01
Self-efficacy	2.70	0.75	.29	3.61	.000	0.99	1.01
Adj. R²=.11, F=9.28, p＜.001, Durbin-Watson=1.99

SE=standard error; VIF=variance inflation factor.

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