Study on the status and countermeasures of disease self-management ability in chronic kidney disease patients in cold regions

Xinrui Wei; Chunlian Li; Hongmei Yu; Lingling Xu; Siwen Meng; Chun Xing; Qiang Gao; Guangming Chang; Yongchen Wang

doi:10.1515/fzm-2025-0002

Abstract：Objective: Effective Chronic Kidney Disease (CKD) management is particularly important in cold regions of China, where climate and lifestyle factors play significant roles. However, there is a lack of relevant studies in this area. Therefore, the purpose of this study was: (1) to assess the status of self-management capacity in individuals with CKD in cold regions of China and analyze the factors influencing it; (2) to identify strategies to improve CKD management in primary care settings in these regions; and (3) to understand patients' attitudes toward eHealth services. Methods: This was a regional, cross-sectional observational study. A questionnaire measuring CKD patients' self-management abilities was derived from the Perceived Kidney Disease Self-Management Scale, the Kidney Disease Behavioral Inventory (KDBI), and the Health Literacy Questionnaire. Data were collected from hospitalized CKD patients in Heilongjiang Province and analyzed using One-Way Analysis of Variance (ANOVA), Hierarchical Regression Analysis, and K-prototype cluster analysis. Results: A total of 957 participants were tested. Of these, 70.64% had less than a bachelor's degree, and 56.27% had been diagnosed with hypertensive or diabetic nephropathy. The KDBI scale showed a lower overall score compared to the PKDSMS. Factors such as CKD stage 4 (F=2.367, P=0.042), last year's medical expenses (F=3.974, P=0.004), and poor self-rated health (F=33.352, P<0.01) were found to influence scores on both scales. The health literacy questionnaire revealed significant differences (P<0.01) in health knowledge, except by sex. Additionally, healthcare expenditures and poor self-rated health were negatively associated with self-management capacity. Conclusion: This study provides valuable insights into the self-management challenges faced by CKD patients in cold regions of China. Despite some difficulties in improving self-management, patients showed positive attitudes toward enhancing CKD management services in primary care and developing digital management tools. These findings offer useful references and recommendations for future clinical practice and research in this field.