Social support and self-management among end-stage renal disease patients undergoing hemodialysis in Indonesia.

Abstract

Background: Self-management is the latest multidisciplinary intervention that empowers end-stage renal disease (ESRD) patients to be active in maintaining their health status. The implementation of self-management among ESRD patients undergoing hemodialysis in Indonesia remains relatively low, contributing to the high prevalence of complications and morbidity. The social cognitive theory proposes that social support is one of the environmental factors affecting health behavior change. Therefore, this study aimed to investigate the association between social support and self-management among ESRD patients undergoing hemodialysis in Indonesia.Design and Methods: A cross-sectional study was conducted among 107 ESRD patients selected by consecutive sampling. Data were collected online from four chronic kidney disease communities in Indonesia in June 2020. Medical Outcome Study Social Support Survey and Hemodialysis Self-Management Instrument were used to measure patients’ functional social support and selfmanagement levels. Statistical analysis using the Chi-square test was applied to evaluate the association between social support and self-management.Results: More than half of the patients had high social support (51%) and good self-management (53%). There was a significant relationship between social support and self-management (p=0.027; α=0.05; odds ratio 95% CI = 2.386).Conclusions: Social support is a potential environmental factor that can be modified to enhance health behavior change among ESRD patients in Indonesia, with the specific behavior being selfmanagement. This study recommends functional social support as an integral part of self-management intervention provided through cooperation between health workers, chronic kidney disease community, and patient companions. Significance for public health The prevalence of end-stage renal disease (ESRD) has significantly increased year over year, yet more than 50% of ESRD patients still do not comply with the recommended lifestyle modifications. Self-management is a new multidisciplinary treatment that empowers ESRD patients to monitor and participate in health care and lifestyle modifications, replacing previous compliance-based treatments. However, the implementation of self-management in Indonesia is still far from ideal. This study indicates a significant relationship between social support on self-management among ESRD patients undergoing hemodialysis in Indonesia. This study can provide new insights for health workers and social networks active in the interaction and care of ESRD patients regarding functional forms of social support that can be applied to support self-management among ESRD patients undergoing hemodialysis.