22 / 33
Page 54
Notes:
conferenceseries
.com
Volume 3, Issue 3 (Suppl)
J Kidney, an open access journal
ISSN:2472-1220
Kidney & Nephrology 2017
August 28-30, 2017
August 28-30, 2017 Philadelphia, USA
15
th
Annual Congress on
Kidney: Nephrology & Therapeutics
The impact of a multidisciplinary self-care management program on quality of life, self-care, adherence
to anti-hypertensive therapy, glycemic control and renal function in diabetic kidney disease: A cross-
over study
Nancy Helou
Haute Ecole de Santé Vaud, Switzerland
D
iabetic Kidney Disease (DKD) is a global health concern that is associated with highmorbidity and mortality. Patients with
DKD are expected to manage their daily self-care activities. Patients’ non-adherence to treatment regimen is thought to be
the major cause for the poor control and the occurrence of complications. Previous research has shown that multidisciplinary
management of DKD can improve patient outcomes. The effect of nurse-led multidisciplinary self-care management on
Quality of Life (QoL), self-care, adherence to antihypertensive therapy, glycemic control and renal function of patients with
DKD is not yet well established. The aim of this study was to investigate the effect of a nurse-led Multidisciplinary Self-care
Management Program (MSMP) on QoL, self-care behavior, adherence to anti-hypertensive therapy, glycemic control and renal
function of adults with DKD. A uniform balanced cross-over design was used with 32 participants randomized into four study
arms. Cross-over designs allow efficient comparison of treatments when recruiting fewer participants and attaining the same
level of statistical power as randomized controlled trials. It is for use more importantly in chronic diseases for comparison of
participants’ responses to different treatments. Each participant receives treatment and serve of own control thus, overcoming
the mixed effects related to heterogeneity of co-morbidities when comparing two different groups. The uniform strongly
balanced design represents the ideal cross-over because it overcomes the statistical bias of carry-over effect. Each participant
received twice, at different time intervals and over 12 months, three months of Usual Care (UC) alternating with three months
of MSMP. QoL was evaluated using the Audit of Diabetes-Dependent QoL scale, patient self-care behavior was measured
using the Revised Summary of Diabetes Self-Care Activities and adherence to anti-hypertensive therapy was assessed using the
Medication Events Monitoring System (MEMS). Blood glucose control was measured by glycated hemoglobin (HbA1c) levels
and renal function by serum creatinine, estimated glomerular filtration rate and urinary albumin/creatinine ratio. The present
QoL was improved by MSMP with a higher mean rank (55.95) as compared to UC (42.19) (p<0.05, Confidence Interval
(CI) of 95%). MSMP also improved the general diet habits, diabetes specific diet habits and blood sugar testing frequency
demonstrating overall higher mean ranks as compared to UC (p<0.01, 95% CI, respectively 59.56 vs. 39.44, 59.98 vs. 37.02
and 57.75 vs. 40.43). Results of glycemic control and renal function did not show a significant difference between MSMP and
UC. MEMS adherence overall percentage mean (n=21) over the 12 months, for UC and MSMP confounded was high (95.38%,
Minimum=69%, Maximum=100%). The implementation of a nurse-led multidisciplinary self-care management program with
a theory-based nursing practice improved general QoL and self-care activities of DKD patients.
Biography
Nancy Helou is an Associate Professor in Nursing Sciences at University of Health Sciences, University of Applied Sciences and Arts of Western Switzerland
(HES-SO). She has completed her PhD in Nursing Sciences from the University of Lausanne, Switzerland. She holds a Master of Science degree in Nutrition and
Dietetics from the American University of Beirut. She has started her academic career in 2004 as a Research Assistant and became an Associate Professor in
2016. She has also build a clinical career as a Cardiac Intensive Care Nurse for four years before becoming a Quality Nurse Manager ensuring Joint Commission
Accreditation and Magnet Designation. She is currently interested in clinical research areas and interdisciplinary work. Her research emphasizes on chronic
diseases prevention and management and patient self-management.
Nancy.HELOU@hesav.chNancy Helou, J Kidney 2017, 3:3 (Suppl)
DOI: 10.4172/2472-1220-C1-002