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The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

Eunji Cha1, Hyojung Park2
Korean Journal of Adult Nursing 2015;27(5):505-514.
Published online: October 31, 2015

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Corresponding author: Park, Hyojung Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-2824, Fax: +82-2-3277-2850, E-mail: hyojungp@ewha.ac.kr
• Received: June 3, 2015   • Accepted: October 5, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to examine their levels of knowledge of the kidney, self-efficacy, and kidney function in pre-dialysis patients with chronic renal insufficiency.
  • Methods
    A total of 142 pre-dialysis patients with chronic renal insufficiency were recruited from a nephrology clinic of a hospital in Korea. Participants knowledge of the kidney, self-efficacy, and kidney function were measured, and the correlations between these factors were computed.
  • Results
    The levels of knowledge of the kidney were moderate, with a mean score of 12.30±5.35. Knowledge level was significantly correlated with age, education level, occupation, income, physical symptoms, and information resources (p<.05). The mean score for self-efficacy was 6.06±2.00. Self-efficacy was significantly associated with patients age, education level, occupation, income, cigarette use, and information resources (p<.05). The mean score for kidney function was 35.66±18.68 mL/min/1.73 m2. Kidney function was significantly correlated with use of medications and drinking behavior (p<.05). Knowledge of the kidney was significantly correlated with self-efficacy (r=.31, p<.001), but not with kidney function. There was a significant correlation between self-efficacy and kidney function (r=.30, p<.001). Multiple regression analysis revealed that self-efficacy and drinking behavior accounted for 11% of the variance in kidney function of pre-dialysis patients with chronic renal insufficiency.
  • Conclusion
    Nursing interventions are necessary to increase self-efficacy among pre-dialysis patients with chronic renal insufficiency in order to maintain their kidney function.
  • Key Words: Chronic renal insufficiency; Glomerular filtration rate; Knowledge; Self efficacy
Table 1.
Demographic Characteristics of the Participants (N=142)
Characteristics Categories n (%) or M±SD
Age (year)   60.50±14.42
＜40 13 (9.2)
40~60 50 (35.2)
＞60 79 (55.6)
Gender Male 87 (61.3)
Female 55 (38.7)
Education Uneducated 6 (4.2)
Elementary school 20 (14.1)
Middle school 19 (13.4)
High school 48 (33.8)
College 43 (30.3)
Graduate school 6 (4.2)
Occupation No 82 (57.7)
Yes 60 (42.3)
Monthly income None 17 (12.0)
Less than $1,000 55 (38.7)
$1,000~$2,000 20 (14.1)
$2,000~$3,000 22 (15.5)
More than $3,000 28 (19.7)
Symptom related to chronic renal insufficiency No 89 (62.7)
Yes 53 (37.3)
   
Medication† HTN 109 (77.3)
DM 53 (37.6)
Hyperlipidemia 49 (34.8)
Diuretic 14 (9.9)
Antithrombosis 12 (8.5)
Smoking None 78 (54.9)
Previous smoking 41 (28.9)
Current smoking 23 (16.2)
Drinking behavior No 100 (70.4)
Yes 42 (29.6)
Information No 93 (65.5)
  Yes 49 (34.5)

DM=diabetes mellitus, HTN=hypertension;

†Multiple response.

Table 2.
Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)
Items M±SD n (%) Range
Knowledge of the kidney 12.30±5.35   0~22
Self-efficacy 6.06±2.00   1~10
Communication with medical professional 6.71±2.70    
Depression control 6.65±2.51    
House work 6.64±2.67    
Getting help from community, family, or friends 6.34±2.47    
Symptom management 5.65±2.44    
Regular exercise 5.56±2.44    
General disease management 5.54±2.38    
Collection of disease related information 4.86±3.10    
Kidney function 35.66±18.68    
Stage 1   1 (0.7)  
Stage 2   17 (12.0)  
Stage 3   61 (43.0)  
Stage 4   44 (31.0)  
Stage 5   19 (13.4)  
Table 3.
Difference among the Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)
Variables Categories n (%) Knowledge of the kidney Self-efficacy Kidney function
M±SD t or F (p) LSD M±SD t or F (p) LSD M±SD t or F (p) LSD
Age (year) ＜40a 13 (9.2) 14.77±1.38 11.09 7.14±0.54 5.49 43.43±5.14 2.19
40~60b 50 (35.2) 14.44±0.71 (＜.001) 6.50±0.27 (.005) 37.69±2.62 (.116)
＞60c 79 (55.6) 10.53±0.56 a, b＞c 5.61±0.22 a, b＞c 33.11±2.09  
Education 　 ≤Middle schoolla 45 (31.7) 10.67±5.67 5.26 5.10±0.28 8.94 23.88±7.57 2.14
High schoolb 48 (33.8) 11.98±5.09 (.006) 6.32±0.27 (＜.001) 37.76±1.99 (.122)
≥Collegec 49 (34.5) 14.10±4.84 a＜c 6.69±0.27 a＜b, c 33.38±2.65  
Occupation Yes 60 (42.3) 14.28±0.66 15.85 6.64±0.25 9.24 33.48±3.64 2.68
No 82 (57.7) 10.84±0.56 (＜.001) 5.64±0.21 (.003) 38.64±2.40 (.104)
Monthly income None 17 (12.0) 12.41±1.27 4.20 6.29±0.46 8.08 37.08±4.56 0.07
＜$2,000 75 (52.8) 11.17±0.60 (.017) 5.48±0.22 (＜.001) 35.25±2.17 (.935)
＞$2,000 50 (35.2) 13.94±0.74   6.87±0.27   35.78±2.66  
Periods of diagnosis (year) ＜1 42 (29.6) 12.05±0.83 0.18 5.97±0.31 2.57 36.08±2.88 1.05
1~5 53 (37.3) 12.15±0.74 (.832) 5.69±0.27 (.080) 32.95±2.57 (.353)
≥5 47 (33.1) 12.67±0.79   6.57±0.29   38.34±2.72  
Smoking Currently smoking 23 (16.2) 12.26±1.12 0.12 4.81±0.40 6.33 34.55±3.90 0.93
Currently non-smoking 41 (28.9) 12.63±0.84 (.888) 6.55±0.30 (.002) 39.01±2.92 (.398)
Non-smoking 78 (54.9) 12.13±0.61   6.18±0.22   34.22±2.12  
Drinking behavior Yes 100 (29.6) 13.14±0.82 1.50 6.27±0.31 0.60 41.05±2.84 5.10
No 42 (70.4) 11.94±0.53 (.223) 5.98±0.20 (.441) 33.40±1.84 (.025)
Symptom Yes 53 (37.3) 14.40±0.70 14.26 5.99±0.28 0.12 37.61±2.57 0.92
No 89 (62.7) 11.05±0.54 (＜.001) 6.11±0.21 (.727) 34.50±1.98 (.338)
Medication Yes 125 (88.0) 12.30±0.48 0.00 5.97±0.18 2.23 33.99±1.63 8.83
No 17 (12.0) 12.29±1.30 (.988) 6.74±0.48 (.138) 47.96±4.41 (.003)
Resources Nonea 94 (66.2) 11.33±0.53 5.55 5.64±0.20 5.37 36.61±1.94 0.38
Health care providerb 27 (19.0) 13.07±0.98 (＜.001) 7.08±0.37 (.002) 32.23±3.62 (.767)
Multimediac 13 (9.2) 13.92±1.42 a＜d 6.20±0.53 a＜b, d 35.69±5.21  
Bothd 8 (5.6) 18.38±1.80   7.37±0.68   35.90±6.65  
Table 4.
Relationships among Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency
Variables Knowledge of the kidney Self-efficacy
r (p) r (p)
Self-efficacy .31 (＜.001)  
Kidney function .07 (.424) .30 (＜.001)
Table 5.
Influencing Factors on the Kidney Function
Variables B SE β t p Tolerance VIF
(Constant) 10.39 6.17   1.69 .094    
Drinking behavior 6.88 3.26 .17 2.11 .036 0.99 1.01
Self-efficacy 2.70 0.75 .29 3.61 .000 0.99 1.01
Adj. R2=.11, F=9.28, p＜.001, Durbin-Watson=1.99

SE=standard error; VIF=variance inflation factor.

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    The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency
    Korean J Adult Nurs. 2015;27(5):505-514.   Published online October 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.5.505
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    The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency
    Korean J Adult Nurs. 2015;27(5):505-514.   Published online October 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.5.505
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    The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency
    The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

    Demographic Characteristics of the Participants (N=142)

    Characteristics Categories n (%) or M±SD
    Age (year)   60.50±14.42
    ＜40 13 (9.2)
    40~60 50 (35.2)
    ＞60 79 (55.6)
    Gender Male 87 (61.3)
    Female 55 (38.7)
    Education Uneducated 6 (4.2)
    Elementary school 20 (14.1)
    Middle school 19 (13.4)
    High school 48 (33.8)
    College 43 (30.3)
    Graduate school 6 (4.2)
    Occupation No 82 (57.7)
    Yes 60 (42.3)
    Monthly income None 17 (12.0)
    Less than $1,000 55 (38.7)
    $1,000~$2,000 20 (14.1)
    $2,000~$3,000 22 (15.5)
    More than $3,000 28 (19.7)
    Symptom related to chronic renal insufficiency No 89 (62.7)
    Yes 53 (37.3)
       
    Medication† HTN 109 (77.3)
    DM 53 (37.6)
    Hyperlipidemia 49 (34.8)
    Diuretic 14 (9.9)
    Antithrombosis 12 (8.5)
    Smoking None 78 (54.9)
    Previous smoking 41 (28.9)
    Current smoking 23 (16.2)
    Drinking behavior No 100 (70.4)
    Yes 42 (29.6)
    Information No 93 (65.5)
      Yes 49 (34.5)

    DM=diabetes mellitus, HTN=hypertension;

    †Multiple response.

    Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

    Items M±SD n (%) Range
    Knowledge of the kidney 12.30±5.35   0~22
    Self-efficacy 6.06±2.00   1~10
    Communication with medical professional 6.71±2.70    
    Depression control 6.65±2.51    
    House work 6.64±2.67    
    Getting help from community, family, or friends 6.34±2.47    
    Symptom management 5.65±2.44    
    Regular exercise 5.56±2.44    
    General disease management 5.54±2.38    
    Collection of disease related information 4.86±3.10    
    Kidney function 35.66±18.68    
    Stage 1   1 (0.7)  
    Stage 2   17 (12.0)  
    Stage 3   61 (43.0)  
    Stage 4   44 (31.0)  
    Stage 5   19 (13.4)  

    Difference among the Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

    Variables Categories n (%) Knowledge of the kidney Self-efficacy Kidney function
    M±SD t or F (p) LSD M±SD t or F (p) LSD M±SD t or F (p) LSD
    Age (year) ＜40a 13 (9.2) 14.77±1.38 11.09 7.14±0.54 5.49 43.43±5.14 2.19
    40~60b 50 (35.2) 14.44±0.71 (＜.001) 6.50±0.27 (.005) 37.69±2.62 (.116)
    ＞60c 79 (55.6) 10.53±0.56 a, b＞c 5.61±0.22 a, b＞c 33.11±2.09  
    Education 　 ≤Middle schoolla 45 (31.7) 10.67±5.67 5.26 5.10±0.28 8.94 23.88±7.57 2.14
    High schoolb 48 (33.8) 11.98±5.09 (.006) 6.32±0.27 (＜.001) 37.76±1.99 (.122)
    ≥Collegec 49 (34.5) 14.10±4.84 a＜c 6.69±0.27 a＜b, c 33.38±2.65  
    Occupation Yes 60 (42.3) 14.28±0.66 15.85 6.64±0.25 9.24 33.48±3.64 2.68
    No 82 (57.7) 10.84±0.56 (＜.001) 5.64±0.21 (.003) 38.64±2.40 (.104)
    Monthly income None 17 (12.0) 12.41±1.27 4.20 6.29±0.46 8.08 37.08±4.56 0.07
    ＜$2,000 75 (52.8) 11.17±0.60 (.017) 5.48±0.22 (＜.001) 35.25±2.17 (.935)
    ＞$2,000 50 (35.2) 13.94±0.74   6.87±0.27   35.78±2.66  
    Periods of diagnosis (year) ＜1 42 (29.6) 12.05±0.83 0.18 5.97±0.31 2.57 36.08±2.88 1.05
    1~5 53 (37.3) 12.15±0.74 (.832) 5.69±0.27 (.080) 32.95±2.57 (.353)
    ≥5 47 (33.1) 12.67±0.79   6.57±0.29   38.34±2.72  
    Smoking Currently smoking 23 (16.2) 12.26±1.12 0.12 4.81±0.40 6.33 34.55±3.90 0.93
    Currently non-smoking 41 (28.9) 12.63±0.84 (.888) 6.55±0.30 (.002) 39.01±2.92 (.398)
    Non-smoking 78 (54.9) 12.13±0.61   6.18±0.22   34.22±2.12  
    Drinking behavior Yes 100 (29.6) 13.14±0.82 1.50 6.27±0.31 0.60 41.05±2.84 5.10
    No 42 (70.4) 11.94±0.53 (.223) 5.98±0.20 (.441) 33.40±1.84 (.025)
    Symptom Yes 53 (37.3) 14.40±0.70 14.26 5.99±0.28 0.12 37.61±2.57 0.92
    No 89 (62.7) 11.05±0.54 (＜.001) 6.11±0.21 (.727) 34.50±1.98 (.338)
    Medication Yes 125 (88.0) 12.30±0.48 0.00 5.97±0.18 2.23 33.99±1.63 8.83
    No 17 (12.0) 12.29±1.30 (.988) 6.74±0.48 (.138) 47.96±4.41 (.003)
    Resources Nonea 94 (66.2) 11.33±0.53 5.55 5.64±0.20 5.37 36.61±1.94 0.38
    Health care providerb 27 (19.0) 13.07±0.98 (＜.001) 7.08±0.37 (.002) 32.23±3.62 (.767)
    Multimediac 13 (9.2) 13.92±1.42 a＜d 6.20±0.53 a＜b, d 35.69±5.21  
    Bothd 8 (5.6) 18.38±1.80   7.37±0.68   35.90±6.65  

    Relationships among Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

    Variables Knowledge of the kidney Self-efficacy
    r (p) r (p)
    Self-efficacy .31 (＜.001)  
    Kidney function .07 (.424) .30 (＜.001)

    Influencing Factors on the Kidney Function

    Variables B SE β t p Tolerance VIF
    (Constant) 10.39 6.17   1.69 .094    
    Drinking behavior 6.88 3.26 .17 2.11 .036 0.99 1.01
    Self-efficacy 2.70 0.75 .29 3.61 .000 0.99 1.01
    Adj. R2=.11, F=9.28, p＜.001, Durbin-Watson=1.99

    SE=standard error; VIF=variance inflation factor.
    Table 1. Demographic Characteristics of the Participants (N=142)

    DM=diabetes mellitus, HTN=hypertension;

    Multiple response.

    Table 2. Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

    Table 3. Difference among the Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (N=142)

    Table 4. Relationships among Knowledge of the Kidney, Self-efficacy and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency

    Table 5. Influencing Factors on the Kidney Function

    SE=standard error; VIF=variance inflation factor.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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