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Browsing by Author "Zimmerman, Lani"
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Item Patient Activation with Knowledge, Self-Management, and Confidence in Chronic Kidney Disease(Wiley, 2016-03) Johnson, Michelle L.; Zimmerman, Lani; Welch, Janet L.; Hertzog, Melody; Pozehl, Bunny; Plumb, Troy; IU School of NursingBackground Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease. Objectives This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease. Design The study employed a descriptive correlational design. Settings Participants were recruited from five primary care, three nephrology clinics and one dialysis centre in two Midwestern cities in the United States. Participants The convenience sample included 85 adults with hypertension, diabetes mellitus and chronic kidney disease, including kidney failure, who spoke English. Measurements Seven measurements were used to collect data via telephone interviews with participants not receiving haemodialysis, and face-to-face interviews with those receiving haemodialysis at the beginning of their treatment session. Results Analyses indicated that half the participants were female (50.58%), the mean age was 63.21 years (SD = 13.11), and participants with chronic kidney disease stage 3 were the most activated. Post hoc differences were significant in patient activation and blood pressure self-management and anxiety across chronic kidney disease stages, excluding stage 5. Conclusion Engaging patients in the self-management of their health care and enhancing patients’ ability to self-manage their blood pressure may work to preserve kidney health. Healthcare providers should collaborate with patients to develop strategies that will maintain patients’ health-related quality of life, like reducing anxiety as kidney disease progress.Item Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review(SAGE, 2015-05) Welch, Janet L.; Johnson, Michelle; Zimmerman, Lani; Russell, Cynthia L.; Perkins, Susan M.; Decker, Brian S.; IU School of NursingThe prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States. Knowledge gaps included the focus on medical self-management tasks with no attention to role or emotional tasks, lack of family involvement during intervention delivery, and an inability to form conclusions about the efficacy of interventions because methodological rigor was insufficient. Educational content varied across studies. Strategies to improve self-management skills and enhance self-efficacy varied and were limited in scope. Further development and testing of theory-based interventions are warranted. There is a critical need for future research using well-designed trials with appropriately powered sample sizes, well-tested instruments, and clear and consistent reporting of results.