P187
HOW CONFIDENT ARE PEOPLE WITH CHRONIC KIDNEY DISEASE (CKD) AT SELFCARE? - A BASELINE SURVEY TO DETERMINE EDUCATIONAL NEEDS
Byrne, J & Carr, S
Renal Department, University Hospitals of Leicester NHS Trust
BACKGROUND & OBJECTIVE: How confident are people with CKD at self-managing their
condition? Self-efficacy is the belief a person has in their own ability to change their behaviour. In patient
education, it is one of the most consistent predictors of self-management behaviour. Self-efficacy is
influenced by a number of external factors including knowledge. Increased knowledge of health risks and
benefits reinforces a person’s self-efficacy and is a precondition required for behavioural change to occur.
To deliver effective patient education requires a good understanding of all these factors to establish what
the educational needs are. We conducted a survey to determine the educational needs of our multi-ethnic
population regarding knowledge, self-efficacy and the ability to self-care.
METHODS: A survey questionnaire was administered over a 4 month period to outpatients attending
pre-dialysis and nephrology clinics. Basic demographic data (sex, age and ethnicity) and prevalence data
for CKD risk factors were collected; and data to ascertain the level of knowledge/awareness about CKD
risks, to establish what information sources patients were using, to explore the prevalence of basic selfcare activities and to find out the level of confidence (self-efficacy) people have to self-care. All data
were collected anonymously.
RESULTS: The survey questionnaire was completed by 101/121 people (an 83% response rate). The
mean age was 62.0 (+/-17), there was a higher percentage of males (56.4%) and 31.3% were of SouthAsian origin. High blood pressure (70.3%) and inactivity (59.1%) were reported as the most prevalent
risks and 58.4% of patients reported two or more CKD risks. The mean self-efficacy score was 5.9 (+/2.5). Patients were more aware of high blood pressure (87.5%), inactivity (96.7%) and obesity (79.8%)
than the other CKD risks. Doctors in kidney clinic were the main source of information for high blood
pressure (79.1%) but other sources (GP, internet) were used to find out about the other CKD risks. The
majority of patients (65.2%) were receiving information on blood pressure targets but very few reported
been advised on targets and recommendations for the other CKD risk factors. For people with high blood
pressure, only 54.5% are self-monitoring. Ethnicity was the only significant predictor of self-efficacy.
White Europeans were statistically more likely to have a higher self-efficacy level than people from a
South Asian origin (59.3% vs 33.3%, p=0.020).
CONCLUSION: Our findings showed that our patients’ knowledge and confidence to self-manage their
condition were limited. South Asian patients, in particular, were less confident. This suggests that a
different strategy is needed to deliver more effective patient education that addresses these key issues. We
are currently using our findings to develop and evaluate some novel resources that will help us to assess
and improve our patients’ knowledge and confidence and get them more involved in their care.