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E-Thesis 357 views 105 downloads

Development of a person-centred, theory-based self-management intervention specific to young adults with chronic kidney disease / Paula Krawiec

Swansea University Author: Paula Krawiec

DOI (Published version): 10.23889/SUthesis.68105

Abstract

Chronic Kidney Disease (CKD) is a rapidly increasing health concern. Healthcare interventions, including self-management interventions (SMIs), can save thousands of lives between now and 2033 (Kidney Research, 2023). CKD management is complex, requiring life-long modifications, especially for young...

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Published: Swansea, Wales, UK 2024
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Rance, Jaynie ; Bennett, Paul ; Gatzemeier, Jennifer
URI: https://cronfa.swan.ac.uk/Record/cronfa68105
Abstract: Chronic Kidney Disease (CKD) is a rapidly increasing health concern. Healthcare interventions, including self-management interventions (SMIs), can save thousands of lives between now and 2033 (Kidney Research, 2023). CKD management is complex, requiring life-long modifications, especially for young adults (YAs) who simultaneously undergo a major life transition. However, support for this vulnerable group is lacking and more research is needed to understand how CKD affects their lives in all aspects. This multi-phase study aimed to review the literature to establish key elements of the existing CKD SMIs (Phase 1) and identify gaps through the collection of quantitative and qualitative data (Phase 2), to inform the development of an appropriate SMI for YAs (aged 18-35 years old) with CKD (all stages), guided by French et al.’ (2012) four-step approach (Phase 3). The literature review identified a lack of personalised, theory-based interventions and emphasised the potential of SMIs in improving self-efficacy compared to usual care. The quantitative (questionnaire study) and qualitative (semi-structured interviews) syntheses revealed a strong agreement on the unmet needs, social factors, psychological disorders, and inconsistent care experienced by YAs, based on their experience and those who look after them. The differences between the two analyses highlighted the complexity of self-managing CKD, emphasising the importance of understanding the various factors that influence it. Finally, the intervention development phase resulted in highly personalised to the unique needs of the target population, theory-based behavioural SMI enhancing YAs’ participation in social activities by improving their communication and self-advocacy skills, enabling them to articulate needs, preferences, and concerns, navigate social perceptions and influences, and seek emotional support when required. This novel intervention holds promise, offering a conceptual basis for understanding how it may operate, however, its future implication and evaluation are necessary to assess its feasibility in real-world settings and capture changes over time.
Keywords: Chronic Kidney Disease; young adults; theory-based self-management interventions; person-centred care; self-efficacy
College: Faculty of Medicine, Health and Life Sciences
Funders: Swansea University; Kidney Wales Foundation