Abstract
Introduction: Patients with chronic kidney disease (CKD) undergoing pre-dialysis requires a good self-management to control low protein intake and maintain kidney function. Adaptation to the existing stimulus through coping and adjustment mechanisms is important to maintaining good kidney function. However, few studies applied nursing theory based to guide intervention in helping the adaptation of patient CKD with their condition. The purpose of this study is to evaluate the effectiveness of Roy’s adaptation model towards physiological and psychological adaptation response among patients with CKD undergoing pre-dialysis.Methods: This study was conducted using a quasi-experiment to patients with CKD pre-dialysis, age over 18 years old. We modified Roy’s adaptation model for patients with CKD undergoing pre-dialysis.Results: A total of 70 subjects agreed to join the study, 38 subjects in intervention and 32 subjects in the control group. The mean of eGFR ranged from 26.3 to 26.6 mL/min/1.73 m2. We found that Roy’s adaptation model has significantly improved drinking behavior, reduce protein intake, blood creatinine, and psychosocial adaptation response after the intervention.Conclusion: These study findings suggested that Roy’s adaptation model is effective to help patients with CKD undergoing pre-dialysis improve their behavior and maintain kidneyfunction . Model dissemination, advocacy to related units, and application in nursing care in patients with chronic kidney disease pre-dialysis are necessary.
Highlights
Patients with chronic kidney disease (CKD) undergoing predialysis requires a good self-management to control low protein intake and maintain kidney function
We found that Roy’s adaptation model has significantly improved drinking behavior, reduce protein intake, blood creatinine, and psychosocial adaptation response after the intervention
Chronic Kidney Disease (CKD) is defined as kidney damage over three months with glomerulus filtration rate (GFR) less than 60 ml/minute/1.73 m2 that consists of five stages (Black and Hawk, 2005; Wein, Kanvoussi, Novick, Partin, Peters, 2007; Thomas, 2008)
Summary
Patients with chronic kidney disease (CKD) undergoing predialysis requires a good self-management to control low protein intake and maintain kidney function. Few studies applied nursing theory based to guide intervention in helping the adaptation of patient CKD with their condition. According to the Indonesian National Health Insurance data, around 70,000 patients with kidney disease required a dialysis, only 12,804 of them already perform a hemodialysis, and above 30,000 patients is recommended to do pre-dialysis. Roy's Adaptation model is one of the nursing theories focused on human adaptation based onstimulus from the internal and external environment. The role of nurses based on Roy's theory is required to assess the adaptability of patients and help them adapt with changes due to the disease and its consequences (Roy, 1991; Tomey and Alligood, 2006)
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