Self-Management of Patients with Early Chronic Kidney Disease: A Concept Analysis
DOI:
https://doi.org/10.31674/mjn.2025.v16i04.032Abstract
Background: Self-management is the management of care in patients with chronic diseases to prevent disease complications and slow the progression of CKD, especially in early CKD patients. Although self-management is critical, there is still a lack of clarity regarding the conceptualisation of self-management in early CKD patients. Concept analysis is needed to understand better the concept and meaning of self-management in early CKD patients. Objectives: The concept analysis aimed to clarify the concept of self-management in early CKD patients by identifying its antecedents, attributes, and consequences. Methods: The method used Walker and Avant’s concept approach through eight steps of analysis to explore the antecedents, attributes, and consequences of the concept of self-management analysis of early CKD patients. Results: Antecedents of self-management in early CKD patients include partnerships with healthcare professionals, problem-solving, self-care, and psychological management. Attributes of this concept include active participation in health care, the ability to manage and care for chronic diseases, and the development of health behaviour in CKD. Consequences of self-management in early CKD patients include caring ability, self-care, independence in carrying out care, and compliance in carrying out health care. Conclusion: This concept analysis can guide nurses in providing self-management interventions in early CKD patients. In addition, this concept can also be used as a guideline for developing self-management intervention programmes in kidney health nursing care.
Keywords:
Chronic Kidney Diseases, Concept Analysis, Self-ManagementDownloads
References
Almutary, H., & Tayyib, N. (2022). Factors Influencing Self-Management among Non-Dialysis Chronic Kidney Disease Patients. Healthcare (Switzerland), 10(3), 1–10. https://doi.org/10.3390/healthcare10030436
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Graham-Brown, M. P. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review. Journal of Nephrology, 36(5), 1267-1281. https://doi.org/10.1007/s40620-022-01537-0
Cardol, C. K., Meuleman, Y., van Middendorp, H., van der Boog, P. J. M., Hilbrands, L. B., Navis, G., Sijpkens, Y. W. J., Sont, J. K., Evers, A. W. M., & van Dijk, S. (2023). Psychological Distress and Self-Management in CKD: A Cross-Sectional Study. Kidney Medicine, 5(10). https://doi.org/10.1016/j.xkme.2023.100712
Chuang, L. M., Wu, S. F. V., Lee, M. C., Lin, L. J., Liang, S. Y., Lai, P. C., & Kao, M. C. (2021). The effects of knowledge and self-management of patients with early-stage chronic kidney disease: Self-efficacy is a mediator. Japan Journal of Nursing Science, 18(2), 1–8. https://doi.org/10.1111/jjns.12388
Cui, Y., Liu, N., Guo, Z., Liu, Q., Zhang, M., Li, J., Mu, H., Zhang, Y., & Chen, X. (2025). Family Function and self-management of patients with early chronic kidney disease: the mediating roles of self-perceived burden and ego depletion. Patient Preference and Adherence , 19(January), 161–172. https://doi.org/10.2147/PPA.S494483
Cui, Y., Yang, T., Li, R., Wang, H., Jin, S., Liu, N., Liu, X., Liu, H., & Zhang, Y. (2023). Network structure of family function and self-management in patients with early chronic kidney disease amid the COVID-19 pandemic. Frontiers in Public Health, 10(22). https://doi.org/10.3389/fpubh.2022.1073409
Davison, S. N., Pommer, W., Brown, M. A., Douglas, C. A., Gelfand, S. L., Gueco, I. P., Hole, B. D., Homma, S., Kazancıoğlu, R. T., Kitamura, H., Koubar, S. H., Krause, R., Li, K. C., Lowney, A. C., Nagaraju, S. P., Niang, A., Obrador, G. T., Ohtake, Y., Schell, J. O., … Brennan, F. P. (2024). Conservative kidney management and kidney supportive care: core components of integrated care for people with kidney failure. Kidney International, 105(1), 35–45. https://doi.org/10.1016/j.kint.2023.10.001
Delatorre, T., Romão, E. A., De Mattos, A. T. R., & Ferreira, J. B. B. (2021). Management of chronic kidney disease: Perspectives of Brazilian primary care physicians. Primary Health Care Research and Development, 22. https://doi.org/10.1017/S1463423621000074
Dingwall, K. M., Nagel, T., Hughes, J. T., Kavanagh, D. J., Cass, A., Howard, K., Sweet, M., Brown, S., Sajiv, C., & Majoni, S. W. (2019). Wellbeing intervention for chronic kidney disease (WICKD): A randomised controlled trial study protocol. BMC Psychology, 7(1). https://doi.org/10.1186/s40359-018-0264-x
Dinh, T. T. H., & Bonner, A. (2023). Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases. BMC Health Services Research, 23(1), 1–10. https://doi.org/10.1186/s12913-023-09907-5
Escudero-Lopez, M., Martinez-Andres, M., Marcilla-Toribio, I., Moratalla-Cebrian, M. L., Perez-Moreno, A., & Bartolome-Gutierrez, R. (2024). Barriers and facilitators in self-care and management of chronic kidney disease in dialysis patients: A systematic review of qualitative studies. Journal of Clinical Nursing, October 2023, 1–16. https://doi.org/10.1111/jocn.17193
Farrell, D. R., & Vassalotti, J. A. (2024). Screening, identifying, and treating chronic kidney disease: why, who, when, how, and what? BMC Nephrology, 25(1), 1–13. https://doi.org/10.1186/s12882-024-03466-5
Garnett, A., Ploeg, J., Markle-Reid, M., & Strachan, P. H. (2018). Self-management of multiple chronic conditions by community-dwelling older adults: A concept analysis. SAGE Open Nursing, 4. https://doi.org/10.1177/2377960817752471
Havas, K., Douglas, C., & Bonner, A. (2018). Meeting patients where they are: Improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study). BMC Nephrology, 19(1), 1–14. https://doi.org/10.1186/s12882-018-1075-2
Hessler, D. M., Fisher, L., Bowyer, V., Dickinson, L. M., Jortberg, B. T., Kwan, B., ... & Dickinson, W. P. (2019). Self-management support for chronic disease in primary care: frequency of patient self-management problems and patient reported priorities, and alignment with ultimate behavior goal selection. BMC Family Practice, 20, 1-10. https://doi.org/doi.org/10.1186/s12875-019-1012-x
Hustrini, N. M. (2023). Chronic Kidney Disease Care in Indonesia: Challenges and Opportunities. Acta Medica Indonesiana, 55(1), 1. Retrieved from: Retrieved from: https://www.actamedindones.org/index.php/ijim/article/view/2403. Accessed on 12th November, 2023.
Kalantar-Zadeh, K., Jafar, T. H., Nitsch, D., Neuen, B. L., & Perkovic, V. (2021). Chronic kidney disease. The Lancet, 398(10302), 786-802. https://doi.org/10.1016/s0140-6736(21)00519-5
Kelepouris, E., St. Peter, W., Neumiller, J. J., & Wright, E. E. (2023). Optimizing multidisciplinary care of patients with chronic kidney disease and type 2 diabetes mellitus. Diabetes Therapy, 14(7), 1111-1136. https://doi.org/10.1007/s13300-023-01416-2
Kim, H. D., & Cruz, A. B. (2021). Psychological Influence of Self-Management on Exercise Self-Confidence, Satisfaction, and Commitment of Martial Arts Practitioners in Korea: A Meta-Analytic Approach. Frontiers in Psychology, 12, 1–12. https://doi.org/10.3389/fpsyg.2021.691974
Liao, H. C., Liang, W. M., Chu, C. L., & Huang, L. C. (2022). A new learning approach to improve nurses' knowledge of and skills in diabetes care. The Journal of Continuing Education in Nursing, 53(2), 90-96. https://doi.org/10.3928/00220124-20220104-10
Lin, C. C., & Hwang, S. J. (2020). Patient-centered self-management in patients with chronic kidney disease: Challenges and implications. International Journal of Environmental Research and Public Health, 17(24), 1–13. https://doi.org/10.3390/ijerph17249443
Luyckx, V. A., Al-Aly, Z., Bello, A. K., Bellorin-Font, E., Carlini, R. G., Fabian, J., ... & Stanifer, J. (2021). Sustainable development goals relevant to kidney health: an update on progress. Nature Reviews Nephrology, 17(1), 15-32. https://doi.org/10.1038/s41581-020-00363-6
Mailani, F., Huriani, E., Muthia, R., & Rahmiwati, R. (2023). Self-management and relating factors among chronic kidney disease patients on hemodialysis: an Indonesian study. Nurse Media Journal of Nursing, 13(1), 109-120. https://doi.org/10.14710/nmjn.v13i1.48708
Moreels, T., Van de Velde, D., Goethals, J., Vanden Wyngaert, K., De Baets, S., Nagler, E., Leune, T., De Vriendt, P., & Van Biesen, W. (2024). Self-Management interventions for facilitating life participation for persons with kidney failure a systematic review. Clinical Journal of the American Society of Nephrology, 19(2), 189–201. https://doi.org/10.2215/CJN.0000000000000347
Mott, A. K. (2021). Diabetes mellitus self-management to decrease the risk for chronic kidney disease. Nephrology Nursing Journal, 48(1), 65-63. https://doi.org/10.37526/1526-744X.2021.48.1.65
Nguyen, N. T., Douglas, C., & Bonner, A. (2019). Effectiveness of self‐management programme in people with chronic kidney disease: A pragmatic randomized controlled trial. Journal of Advanced Nursing, 75(3), 652-664. https://doi.org/10.1111/jan.13924
Niu, S. F., Wu, C. K., Chuang, N. C., Yang, Y. B., & Chang, T. H. (2021). Early Chronic Kidney Disease Care Programme delays kidney function deterioration in patients with stage I-IIIa chronic kidney disease: An observational cohort study in Taiwan. BMJ Open, 11(1). https://doi.org/10.1136/bmjopen-2020-041210
Ouyang, W. wei, Chen, H. fen, Xu, X. yi, Zhang, X. long, Fu, L. zhe, Tang, F., Wen, Z. huai, Marrone, G., Liu, L. chang, Lin, J. xia, Liu, X. sheng, & Wu, Y. fan. (2022). Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study. BMC Nephrology, 23(1), 1–11. https://doi.org/10.1186/s12882-022-02700-2
Ozieh, M. N., & Egede, L. E. (2022). A Lifestyle Intervention to Delay early chronic kidney disease in african americans with diabetic kidney disease: pre-post pilot study. JMIR Formative Research, 6(3). https://doi.org/10.2196/34029
Peng, S., He, J., Huang, J., Lun, L., Zeng, J., Zeng, S., Zhang, L., Liu, X., & Wu, Y. (2019). Self-management interventions for chronic kidney disease: A systematic review and meta-analysis. BMC Nephrology, 20(1) 1-13. https://doi.org/10.1186/s12882-019-1309-y
Sahely, A., Giles, D., Sintler, C., Soundy, A., & Rosewilliam, S. (2023). Self-management interventions to improve mobility after stroke: an integrative review. Disability and Rehabilitation, 45(1), 9-26. https://doi.org/10.1080/09638288.2022.2028019
Sezer, T. A., Çavuşoğlu, H., & Düzova, A. (2021). Self‐management program for adolescents with chronic kidney disease: A randomized controlled trial. Journal of Renal Care, 47(3), 146-159. https://doi.org/10.1111/jorc.12357
Suarilah, I., & Lin, C. C. (2022). Factors influencing self‐management among Indonesian patients with early‐stage chronic kidney disease: A cross‐sectional study. Journal of clinical nursing, 31(5-6), 703-715. https://doi.org/10.1111/jocn.15930
Thanachayanont, T., Chanpitakkul, M., Hengtrakulvenit, J., Watcharakanon, P., Wisansak, W., Tancharoensukjit, T., ... & ESCORT‐2 Research Team. (2021). Effectiveness of integrated care on delaying chronic kidney disease progression in rural communities of Thailand (ESCORT‐2) trials. Nephrology, 26(4), 333-340. https://doi.org/10.1111/nep.13849
Tsai, Y. C., Wang, S. L., Tsai, H. J., Chen, T. H., Kung, L. F., Hsiao, P. N., Hsiao, S. M., Hwang, S. J., Chen, H. C., & Chiu, Y. W. (2021). The interaction between self-care behavior and disease knowledge on the decline in renal function in chronic kidney disease. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-020-79873-z
Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Pearson. Retrieved from: https://dehaghan.iau.ir/file/download/page/1673866274-strategies-for-theory-construction-in-nursing.pdf . Accessed on 15th November, 2023.
Yeboah, M., & Hollis, N. (2024). Implementing Life care planning in chronic disease management. The Journal for Nurse Practitioners, 20(6). https://doi.org/10.1016/j.nurpra.2024.104947
Zhao, Z., Ren, P., & Yang, Q. (2023). Student Self-Management, Academic Achievement: Exploring the Mediating Role of Self-Efficacy and the Moderating Influence of Gender—Insights From a Survey Conducted in 3 Universities in America. Journal of Integrated Social Sciences and Humanities, 1(1), 1–12. https://doi.org/10.62836/jissh.v1i1.159
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 The Malaysian Journal of Nursing (MJN)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.