REGRESSION ANALYSIS OF NURSING AGENCY, SELF-CARE DEMAND, AND SELF-CARE AGENCY ON QUALITY OF LIFE AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE

Kamaliah Ainun

Authors

Kamaliah Ainun Philippine Women's University

Keywords:

Chronic Kidney Disease, Nursing Agency, Self-care Agency, Quality of Life, Self-care Demand

Abstract

Background: Chronic Kidney Disease (CKD) is a progressive condition that significantly reduces patients’ quality of life (QoL) in physical, psychological, and social aspects. Nursing agency, self-care demand, and self-care agency are considered important determinants influencing patient outcomes. Objective: This study aimed to analyze the effects of nursing agency, self-care demand, and self-care agency on QoL among CKD patients, including the mediating role of self-care agency. Methods: A quantitative cross-sectional study with correlational, multiple linear regression, and mediation analysis was conducted among 223 CKD patients at Haji Medan Public Hospital. Data were collected using validated instruments: Nursing Agency Scale, Self-Care Demand Scale, Self-Care Agency Instrument, and WHOQOL-BREF. Statistical analysis was performed using SPSS. Results: The mean scores were 4.17 ± 0.49 for nursing agency, 3.06 ± 0.71 for self-care demand, 3.26 ± 0.67 for self-care agency, and 3.02 ± 0.67 for quality of life. Nursing agency showed a significant positive correlation with QoL (r = 0.214; p = 0.001), as did self-care agency (r = 0.238; p < 0.001). Self-care demand was not significantly associated with QoL (r = 0.061; p = 0.361). Regression analysis confirmed nursing agency (β = 0.1733; p = 0.004) and self-care agency (β = 0.1810; p = 0.001) as significant predictors of QoL, while self-care demand was not significant (β = -0.0200; p = 0.798). Conclusion: QoL in CKD patients is primarily influenced by nursing agency and self-care agency, while self-care demand has no significant effect. Strengthening nursing support and patient self-management capacity is essential to improving outcomes.

References

Almutary, H., & Tayyib, N. (2022). Factors Influencing Self-Management among Non-Dialysis Chronic Kidney Disease Patients. Healthcare (Switzerland), 10(3), 1–9. https://doi.org/10.3390/healthcare10030436

Armstrong, N. E., Reid, K. M., & Todd, D. M. (2022). Exploring the Self-care Practices and Needs of Entry-Level Nursing Students: A Pilot Project. International Journal of Studies in Nursing, 7(3), 10. https://doi.org/10.20849/ijsn.v7i3.1234

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

Hendrik Prayitno Luawo, Yulia Indah Permata, Ulfa Nur Rohmah, Waluyo Waluyo, S. A. A. (2019). CRITICAL MEDICAL AND SURGICAL NURSING JOURNAL ( Jurnal Keperawatan Medikal Bedah dan Kritis ) Summary of Self-Management Program for Patients with CKD : A Systematic Review. 8(2), 70–74.

Kefale, B., Alebachew, M., Tadesse, Y., & Engidawork, E. (2019). Quality of life and its predictors among patients with chronic kidney disease : A hospital-based cross-sectional study. 1–16. https://doi.org/10.1371/journal.pone.0212184

Kovesdy, C. P. (2022). Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements, 12(1), 7–11. https://doi.org/10.1016/j.kisu.2021.11.003

Maringhini, S., & Zoccali, C. (2024). Chronic Kidney Disease Progression — A Challenge. 1–16.

Lightfoot, C. J., Nair, D., Bennett, P. N., Smith, A. C., Griffin, A. D., Warren, M., & Wilkinson, T. J. (2022). Patient Activation : The Cornerstone of Effective Self-Management in Chronic Kidney Disease ? 91–105.

Senanayake, S., Gunawardena, N., Palihawadana, P., Senanayake, S., & Karunarathna, R. (2020). Health-related quality of life in chronic kidney disease : a descriptive study in a rural Sri Lankan community affected by chronic kidney disease. 1, 1–9.

Wahyuni, M. M. D. (2022). Pengembangan model self-care berbasis dukungan sosial untuk meningkatkan kualitas hidup pasien gagal ginjal kronik dengan hemodialisis di Rsud Prof. Dr. W.Z. Johannes Kota Kupang. https://osf.io/preprints/osf/fn4ua