Abstract
Chronic kidney disease (CKD) is a global public health issue that is associated with high rates of morbidity and mortality. Self-care behavior has been associated with clinical outcomes in chronic diseases, and adequate self-care behavior may mitigate adverse outcomes. Health literacy may be an important factor associated with self-care. The aim of this study was to examine the relationships between different domains of self-care behavior and health literacy in patients with CKD. This study enrolled 208 patients with CKD stages 1–5 who were not undergoing renal replacement therapy at Kaohsiung Medical University Hospital from April 2019 to January 2020. Health literacy was measured using a multidimensional health literacy questionnaire covering the following five dimensions: accessing, understanding, appraising, and applying health information, and communication/interaction. The CKD Self-Care scale, which is a 16-item questionnaire with five domains including medication adherence, diet control, exercise, smoking behavior, and home blood pressure monitoring was used to assess self-care behavior. Among the 208 patients, 97 had sufficient or excellent health literacy, and 111 had inadequate or limited/problematic health literacy. A higher health literacy score was significantly correlated with greater self-care behavior. Among the five domains of self-care behavior, the patients who had sufficient or excellent health literacy had higher diet, exercise, and home blood pressure monitoring scores than those who had inadequate or limited/problematic health literacy. This study demonstrated that health literacy was significantly and positively correlated with self-care behavior in patients with CKD.
Highlights
The stage of Chronic kidney disease (CKD) was defined according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines as stage 1 ≥ 90 mL/min/1.73 m2 ; stage 2
Among the five domains of self-care behavior, the diet, exercise, and home blood pressure monitoring scores were higher in the patients with sufficient or excellent health literacy than in those with inadequate or limited/problematic health literacy
We further evaluated thelog-formed correlation between different comratio. b The multivariable adjusted model included age, sex, education, body mass index, uric acid, and log-formed gly-high ponents of health literacy and self-care behavior and found that patients with cated hemoglobin. c The multivariable adjusted model included age, sex, duration of chronic kidney disease care, number scores of accessing, understanding, and appraising had better general self-care behavior of health education sessions, occupation, log-formed triglyceride, and log-formed urine protein-creatinine ratio. d The in the multivariate analysis (Table 3)
Summary
Given its high prevalence and the risk of progression to end-stage renal disease (ESRD) if left unmanaged, CKD places a huge financial burden on global healthcare systems [5]. Taiwan has the highest prevalence of ESRD in the world, with 82,031 patients receiving dialysis in 2017 [6], accounting for 0.35% of the total population. The medical costs of dialysis accounted for largest share of the overall healthcare budget, at 9.1% [7]. To decrease the risk of CKD progressing to ESRD it is vital to elucidate potential clinical variables that impact a patient’s participation in CKD care and interventions that can be tailored [8]
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