Effective Case Management Incorporating the Empowerment Concept in Chronic Kidney Disease Care

Background: Chronic Renal Disease (CKD) is heavy burden on health care. Despite substantial efforts for prevention in last few years, the prevalence and incidence of CKD in Taiwan has remained the highest in the world. Reforming the care model to improve disease management is an imperative task for health professionals. Methods: This was a quasi-experimental repeating measurement design. There were 47 subjects received empowerment intervention in the experimental group for 3 months; 63 subjects received current care in the control group. The data of outcome indictors were collected at 3 different time points from questionnaires and chart review. Data were analyzed using GEE and GLMM. Results: The levels of empowerment for the experimental group increased significantly right after intervention (â=90.73, p=0.00) and the 3-month follow-up (â=57.68, p=0.00). This intervention lead to sustained significant improvements in self-management scores for the experimental group right after intervention (â=12.86, p=0.00) and the follow-up period (â=7.96, p=0.00). The glomerular filtration rate improved significantly right after intervention and the 3-month follow-up. The biomarkers significantly delayed renal function deterioration in the experimental group (â=4.67, t=4.49**; â=3.18, t=4.00**). No significant differences were found in anemia status, but the experimental group had a better status than the control group. Conclusion: The results confirmed the utility of applying the empowerment concept in CKD care to provide a patient-center care model that enables patients to learn skills and implement self-care continuously and effectively. Case managers continually accompany and provide assistance to strengthen patient's self-management. Patients can effectively prolong CKD progression simultaneously.