Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Objectives: To study the problems and needs for delaying kidney progression, to develop a self-management model, and to evaluate its effects on knowledge, behaviors, and clinical outcomes among patients with chronic kidney disease (CKD) stages 3 and 4. Methods: This research and development study was conducted in four phases: 1) situation analysis involving a purposive sample of 8 multidisciplinary healthcare professionals and 10 patients with CKD stages 3 and 4; 2) model development; 3) implementation; and 4) outcome evaluation among 30 patients at a CKD clinic in September 2025 for a period of 4 weeks. Research instruments included in-depth interview guides, knowledge and health behavior assessment forms, laboratory result records, and a self-management program. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics and paired t-tests. Results: In-depth interviews revealed key issues: 1) patients' lack of awareness regarding self-care to delay kidney progression, 2) insufficient self-monitoring and assessment, and 3) the need for engagement between healthcare providers and patients. Consequently, a self-management model was developed, comprising: 1) educational activities on CKD and preventive behaviors, 2) self-monitoring methods, and 3) a multidisciplinary participatory care approach. Post-implementation, the sample showed significantly increased mean scores in knowledge (5.76±1.19 vs. 9.90±0.40; p<0.001) and health behaviors (4.29±0.50 vs. 4.87±0.24; p<0.001). Clinical outcomes also improved, with an increase in estimated glomerular filtration rate (eGFR) (32.29±8.86 vs.35.03±8.86; p=0.002), and a decrease in urine microalbumin (113.83±150.26 vs. 51.23±44.79; p=0.009). Conclusion: The developed self-management model effectively improved knowledge, health behaviors, and clinical outcomes across all domains for patients with CKD stages 3 and 4.
Authors: Uppor, Wassana, Suthidee, Weena
Language: Thai
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7217417853