254885 Effective Case Management Incorporating the Empowerment Concept in Chronic Kidney Disease Care

Monday, October 29, 2012

Yu-Chi Chen , Department of Nursing, National Yang-Ming University, Taipei, Taiwan
I-Chuan Li , Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan
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 (=90.73, p=0.00) and the 3-month follow-up (=57.68, p=0.00). This intervention lead to sustained significant improvements in self-management scores for the experimental group right after intervention (=12.86, p=0.00) and the follow-up period (=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 (=4.67, t=4.49**; =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.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
1.To analyze the effectiveness of incorporating the empowerment concept for the patients self-management behavior in case management care model. 2.To evaluate the effectiveness of interventions with the empowerment concept for delaying chronic kidney disease progress to end-stage renal disease.

Keywords: Chronic Diseases, Self-Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple health department of government funded grants focusing on the health promotion, chronic disease prevention and case management of kidney disease. Among my scientific interests has been the development of strategies for preventing chronic disease and improving the self-management of DM and CKD patients,community health care system and health policy etc.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.