Stress Adaptation as an Improvement Effort Self- Management and Quality of Life in Patients with Chronic Kidney Disease: A Literature Review
Abstract
Chronic Kidney Disease (CKD) is a significant health issue closely associated with mortality. The prevalence of this disease has been increasing significantly worldwide each year. It is characterized by a permanent decline in kidney function that cannot be reversed within three months or even many years. Eventually, the kidneys may cease to function properly. Failure to adapt to stress impacts the mechanism of coping, self-awareness self-control, and self-efficacy decreasing that impact on self-management and quality of life. This research aims to illustrate the influence of adaptation to stress as effort enhancement self-management and quality of life in patients with chronic kidney disease. A systematic review using the PRISMA protocol and the JBI Critical Appraisal Tool was used to determine which articles met the three requirements of electronic databases (PubMed, Google Scholar, ScienceDirect ). Inclusion criteria include the quality of life of chronic kidney disease patients published in English within the last 5 years (2019-2024). This summarizes twenty - two articles. Discuss the influence of adaptation to stress, self-management, and quality of life for patients with chronic kidney disease. Self-management and quality of life in patients with chronic kidney disease are influenced by adaptive stress, including 1) Focal stimuli (level of severity, duration of hemodialysis, symptoms), 2) Contextual stimuli (distance to health facility, family support, power of health support, satisfaction with health service, employment, economic status, health insurance, marital status), 3) Residual stimuli (age, religion, level of education, sex of type). Positive coping strategies, self-awareness, self-control, and self-efficacy can improve the adaptation process to stress, thus having a positive impact on self-management and quality of life in patients with chronic kidney disease.
References
Al Sawad, A. A., Lim, S. K., Tang, L. Y., Rashid, A. A., & Chew, B. H. (2022). Cultural adaptation and validation of the Malay Chronic Kidney Disease Self-management instrument (MCKD-SM). BMC Nephrology, 23(1), 1–12. https://doi.org/10.1186/s12882-022-03016-x
Alligood, M. R. (2018). Nursing Theorritists And Their Work (M. St.Lois (ed.); Previous e). Elsevier.
Alshelleh, S., Alhouri, A., Taifour, A., Abu-Hussein, B., Alwreikat, F., Abdelghani, M., Badran, M., Al-Asa’d, Y., Alhawari, H., & Oweis, A. O. (2022). Prevelance of depression and anxiety with their effect on quality of life in chronic kidney disease patients. Scientific Reports, 12(1), 1–9. https://doi.org/10.1038/s41598-022-21873-2
Ashrafi, S. A., Alam, R. B., Kraay, A., Ogunjesa, B. A., & Schwingel, A. (2024). Disparities in healthcare access experienced by Hispanic chronic kidney disease patients : a cross ‑ sectional analysis. Journal of Health, Population and Nutrition, 1–9. https://doi.org/10.1186/s41043-024-00508-4
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Graham-Brown, M. P. M. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review. Journal of Nephrology, 36(5), 1267–1281. https://doi.org/10.1007/s40620-022-01537-0
Browning Callis, A. M. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56(April), 151340. https://doi.org/10.1016/j.apnr.2020.151340
Bowling, J., Montanaro, E., Cramer, R. J., Mennicke, A., Wilsey, C. N., Kaniuka, A. R., Wright, S., Macchia, J. M., Langhinrichsen-Rohling, J., & Heron, K. E. (2023). Gender, sexual orientation, and mental health in the kink community: an application of coping self-efficacy theory. Psychology and Health, 38(4), 478–493. https://doi.org/10.1080/08870446.2021.1973001
Cardol, C. K., Meuleman, Y., van Middendorp, H., van der Boog, P. J. M., Hilbrands, L. B., Navis, G., Sijpkens, Y. W. J., Sont, J. K., Evers, A. W. M., & van Dijk, S. (2023). Psychological Distress and Self-Management in CKD: A Cross-Sectional Study. Kidney Medicine, 5(10), 100712. https://doi.org/10.1016/j.xkme.2023.100712
Chen, W. C., Lin, C. C., Wu, C. C., & Song, Y. C. (2021). Psychometric testing of the hemodialysis self-management instrument (HDSMI-18): A confirmatory factor analysis. Nursing Open, 8(5), 2832–2839. https://doi.org/10.1002/nop2.867
Chesnaye, N. C., Meuleman, Y., de Rooij, E. N. M., Hoogeveen, E. K., Dekker, F. W., Evans, M., Pagels, A. A., Caskey, F. J., Torino, C., Porto, G., Szymczak, M., Drechsler, C., Wanner, C., & Jager, K. J. (2022). Health-Related Quality-of-Life Trajectories over Time in Older Men and Women with Advanced Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 17(2), 205–214. https://doi.org/10.2215/CJN.08730621
Dos Santos, D. G. M., Pallone, J. M., Manzini, C. S. S., Zazzetta, M. S., & Orlandi, F. de S. (2021). Relationship between frailty, social support and family functionality of hemodialysis patients: A cross-sectional study. Sao Paulo Medical Journal, 139(6), 570–575. https://doi.org/10.1590/1516-3180.2021.0089.R1.0904221
Fletcher, B. R., Damery, S., Aiyegbusi, O. L., Anderson, N., Calvert, M., Cockwell, P., Ferguson, J., Horton, M., Paap, M. C. S., Sidey-Gibbons, C., Slade, A., Turner, N., & Kyte, D. (2022). Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Medicine, 19(4), 1–25. https://doi.org/10.1371/journal.pmed.1003954
García-Martínez, P., Ballester-Arnal, R., Gandhi-Morar, K., Castro-Calvo, J., Gea-Caballero, V., Juárez-Vela, R., Saus-Ortega, C., Montejano-Lozoya, R., Sosa-Palanca, E. M., Gómez-Romero, M. D. R., & Collado-Boira, E. (2021). Perceived stress in relation to quality of life and resilience in patients with advanced chronic kidney disease undergoing hemodialysis. International Journal of Environmental Research and Public Health, 18(2), 1–10. https://doi.org/10.3390/ijerph18020536
Gebrie, M. H., Asfaw, H. M., Bilchut, W. H., Lindgren, H., & Wettergren, L. (2022). Psychometric properties of the kidney disease quality of life-36 (KDQOL-36) in Ethiopian patients undergoing hemodialysis. Health and Quality of Life Outcomes, 20(1), 1–10. https://doi.org/10.1186/s12955-022-01932-y
Ghasemi Bahraseman, Z., Mangolian Shahrbabaki, P., & Nouhi, E. (2021). The impact of stress management training on stress-related coping strategies and self-efficacy in hemodialysis patients: a randomized controlled clinical trial. BMC Psychology, 9(1), 1–9. https://doi.org/10.1186/s40359-021-00678-4
Ghazi, L., Osypuk, T. L., MacLehose, R. F., Luepker, R. V., & Drawz, P. E. (2021). Neighborhood Socioeconomic Status, Health Insurance, and CKD Prevalence: Findings From a Large Health Care System. Kidney Medicine, 3(4), 555-564.e1. https://doi.org/10.1016/j.xkme.2021.03.008
Helou, N., Talhouedec, D., Zumstein-Shaha, M., & Zanchi, A. (2020). A multidisciplinary approach for improving quality of life and self-management in diabetic kidney disease: A crossover study. Journal of Clinical Medicine, 9(7), 1–14. https://doi.org/10.3390/jcm9072160
International Society of Nephrology. (2023). Global Kidney Health Atlas. In ISN: Internacional Society of Nephrology.
Keivan, S., Shariati, A., Miladinia, M., & Haghighizadeh, M. H. (2023). Role of self-management program based on 5A nursing model in quality of life among patients undergoing hemodialysis: a Randomized Clinical Trial. BMC Nephrology, 24(1), 1–8. https://doi.org/10.1186/s12882-023-03108-2
Kidney Disease Improving Global Outcame. (2023). Clinical practice guideline for evaluation and manegement of chronic disease. Kidney International Supplements, July.
Kreibich, A., Hennecke, M., & Brandstätter, V. (2020). The Effect of Self-awareness on the Identification of Goal-related Obstacles. European Journal of Personality, 34(2), 215–233. https://doi.org/10.1002/per.2234
Krishnan, A., Teixeira-Pinto, A., Lim, W. H., Howard, K., Chapman, J. R., Castells, A., Roger, S. D., Bourke, M. J., Macaskill, P., Williams, G., Lok, C. E., Diekmann, F., Cross, N., Sen, S., Allen, R. D. M., Chadban, S. J., Pollock, C. A., Turner, R., Tong, A., … Craig, J. C. (2020). Health-Related Quality of Life in People Across the Spectrum of CKD. Kidney International Reports, 5(12), 2264–2274. https://doi.org/10.1016/j.ekir.2020.09.028
Lai, P. C., Wu, S. F. V., Alizargar, J., Pranata, S., Tsai, J. M., & Hsieh, N. C. (2021). Factors influencing self-efficacy and self-management among patients with pre-end-stage renal disease (Pre-esrd). Healthcare (Switzerland), 9(3), 1–12. https://doi.org/10.3390/healthcare9030266
Lestarisa, T., Hakim, S. R. L., Arifin, S., Carmelita4, A. B., & Widiarti, A. (2023). Correlation Between Duration of Hemodialysis and Quality of Life of Chronic Kidney Disease Patients Undergoing Hemodialysis in Dr . Doris Sylvanus Regional Public Hospital Palangka ... Advance Research Journal of Multidisciplinary Discoveries (ARJMD), 78(1), 1.
Lin, C. C., & Hwang, S. J. (2020). Patient-centered self-management in patients with chronic kidney disease: Challenges and implications. International Journal of Environmental Research and Public Health, 17(24), 1–13. https://doi.org/10.3390/ijerph17249443
Naseef, H. H., Haj Ali, N., Arafat, A., Khraishi, S., AbuKhalil, A. D., Al-Shami, N., Ladadweh, H., Alsheikh, M., Rabba, A. K., Asmar, I. T., & Sahoury, Y. (2023). Quality of Life of Palestinian Patients on Hemodialysis: Cross-Sectional Observational Study. The Scientific World Journal, 2023, 1–8. https://doi.org/10.1155/2023/4898202
Nilsen, F. A., Bang, H., Boe, O., Martinsen, Ø. L., Lang-Ree, O. C., & Røysamb, E. (2020). The Multidimensional Self-Control Scale (MSCS): Development and validation. Psychological Assessment, 32(11), 1057–1074. https://doi.org/10.1037/pas0000950
Nirat, A. D., Raghunath, D., Rai, S., Dixit, S., & Doharey, S. (2024). Assess The Knowledge , Perception , Level Of Satisfaction And Quality Of Life Of Beneficiaries Utilising Services Of Pradhan Mantri National Dialysis Program ( PMNDP ). 14(1). https://doi.org/10.5530/ijmedph.2024.1.24
Oh, T. R., Choi, H. S., Kim, C. S., Bae, E. H., Oh, Y. K., Kim, Y. S., Choi, K. H., Kim, S. W., & Ma, S. K. (2019). Association between health related quality of life and progression of chronic kidney disease. Scientific Reports, 9(1), 1–9. https://doi.org/10.1038/s41598-019-56102-w
Ouyang, W. wei, Chen, H. fen, Xu, X. yi, Zhang, X. long, Fu, L. zhe, Tang, F., Wen, Z. huai, Marrone, G., Liu, L. chang, Lin, J. xia, Liu, X. sheng, & Wu, Y. fan. (2022). Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study. BMC Nephrology, 23(1), 1–11. https://doi.org/10.1186/s12882-022-02700-2
Pauly, M., Mateti, U. V., Shenoy, P., Saj, N., & Philip, M. L. (2020). Dimensions of quality of life in the different stages of chronic kidney disease patients – A cross-sectional study. Clinical Epidemiology and Global Health, 8(3), 797–801. https://doi.org/10.1016/j.cegh.2020.02.002
Ranabhat, K., Khanal, P., Mishra, S. R., Khanal, A., Tripathi, S., & Sigdel, M. R. (2020). Health related quality of life among end stage renal disease patients from low income country, Nepal: a cross sectional study using WHOQOL-BREF. 1–18.
Riegel, B., Jaarsma, T., Lee, C. S., & Strömberg, A. (2019). Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science, 42(3), 206–215. https://doi.org/10.1097/ANS.0000000000000237
Rosén, H., Ahlström, G., & Lexén, A. (2020). Psychometric properties of the WHOQOL-BREF among next of kin to older persons in nursing homes. Health and Quality of Life Outcomes, 18(1), 1–11. https://doi.org/10.1186/s12955-020-01345-9
Sheth, M. S., Castle, D. J., Wang, W., Lee, A., Jenkins, Z. M., & Hawke, L. D. (2023). Changes to coping and its relationship to improved wellbeing in the optimal health program for chronic disease. SSM - Mental Health, 3(August 2022), 100190. https://doi.org/10.1016/j.ssmmh.2023.100190
Shlipak, M. G., Tummalapalli, S. L., Boulware, L. E., Grams, M. E., Ix, J. H., Jha, V., Kengne, A. P., Madero, M., Mihaylova, B., Tangri, N., Cheung, M., Jadoul, M., Winkelmayer, W. C., Zoungas, S., Abraham, G., Ademi, Z., Alicic, R. Z., de Boer, I., Deo, R., … Zomer, E. (2021). The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 99(1), 34–47. https://doi.org/10.1016/j.kint.2020.10.012
Skoumalova, I., Madarasova Geckova, A., Rosenberger, J., Majernikova, M., Kolarcik, P., Klein, D., de Winter, A. F., van Dijk, J. P., & Reijneveld, S. A. (2022). Low Health Literacy Is Associated with Poorer Physical and Mental Health-Related Quality of Life in Dialysed Patients. International Journal of Environmental Research and Public Health, 19(20). https://doi.org/10.3390/ijerph192013265
Tannor, E. K., Norman, B. R., Adusei, K. K., Sarfo, F. S., Davids, M. R., & Bedu-Addo, G. (2019). Quality of life among patients with moderate to advanced chronic kidney disease in Ghana - A single centre study. BMC Nephrology, 20(1), 1–10. https://doi.org/10.1186/s12882-019-1316-z
Zhang, T., Liu, C., & Ni, Z. (2019). Association of access to healthcare with self-assessed health and quality of life among old adults with chronic disease in china: Urban versus rural populations. International Journal of Environmental Research and Public Health, 16(14). https://doi.org/10.3390/ijerph16142592
(Browning) Callis, A. M. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56(April), 151340. https://doi.org/10.1016/j.apnr.2020.151340
Al Sawad, A. A., Lim, S. K., Tang, L. Y., Rashid, A. A., & Chew, B. H. (2022). Cultural adaptation and validation of the Malay Chronic Kidney Disease Self-management instrument (MCKD-SM). BMC Nephrology, 23(1), 1–12. https://doi.org/10.1186/s12882-022-03016-x
Alligood, M. R. (2018). Nursing Theorritists And Their Work (M. St.Lois (ed.); Previous e). Elsevier.
Alshelleh, S., Alhouri, A., Taifour, A., Abu-Hussein, B., Alwreikat, F., Abdelghani, M., Badran, M., Al-Asa’d, Y., Alhawari, H., & Oweis, A. O. (2022). Prevelance of depression and anxiety with their effect on quality of life in chronic kidney disease patients. Scientific Reports, 12(1), 1–9. https://doi.org/10.1038/s41598-022-21873-2
Ashrafi, S. A., Alam, R. B., Kraay, A., Ogunjesa, B. A., & Schwingel, A. (2024). Disparities in healthcare access experienced by Hispanic chronic kidney disease patients : a cross ‑ sectional analysis. Journal of Health, Population and Nutrition, 1–9. https://doi.org/10.1186/s41043-024-00508-4
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Graham-Brown, M. P. M. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review. Journal of Nephrology, 36(5), 1267–1281. https://doi.org/10.1007/s40620-022-01537-0
Bowling, J., Montanaro, E., Cramer, R. J., Mennicke, A., Wilsey, C. N., Kaniuka, A. R., Wright, S., Macchia, J. M., Langhinrichsen-Rohling, J., & Heron, K. E. (2023). Gender, sexual orientation, and mental health in the kink community: an application of coping self-efficacy theory. Psychology and Health, 38(4), 478–493. https://doi.org/10.1080/08870446.2021.1973001
Cardol, C. K., Meuleman, Y., van Middendorp, H., van der Boog, P. J. M., Hilbrands, L. B., Navis, G., Sijpkens, Y. W. J., Sont, J. K., Evers, A. W. M., & van Dijk, S. (2023). Psychological Distress and Self-Management in CKD: A Cross-Sectional Study. Kidney Medicine, 5(10), 100712. https://doi.org/10.1016/j.xkme.2023.100712
Chen, W. C., Lin, C. C., Wu, C. C., & Song, Y. C. (2021). Psychometric testing of the hemodialysis self-management instrument (HDSMI-18): A confirmatory factor analysis. Nursing Open, 8(5), 2832–2839. https://doi.org/10.1002/nop2.867
Chesnaye, N. C., Meuleman, Y., de Rooij, E. N. M., Hoogeveen, E. K., Dekker, F. W., Evans, M., Pagels, A. A., Caskey, F. J., Torino, C., Porto, G., Szymczak, M., Drechsler, C., Wanner, C., & Jager, K. J. (2022). Health-Related Quality-of-Life Trajectories over Time in Older Men and Women with Advanced Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 17(2), 205–214. https://doi.org/10.2215/CJN.08730621
Dos Santos, D. G. M., Pallone, J. M., Manzini, C. S. S., Zazzetta, M. S., & Orlandi, F. de S. (2021). Relationship between frailty, social support and family functionality of hemodialysis patients: A cross-sectional study. Sao Paulo Medical Journal, 139(6), 570–575. https://doi.org/10.1590/1516-3180.2021.0089.R1.0904221
Fletcher, B. R., Damery, S., Aiyegbusi, O. L., Anderson, N., Calvert, M., Cockwell, P., Ferguson, J., Horton, M., Paap, M. C. S., Sidey-Gibbons, C., Slade, A., Turner, N., & Kyte, D. (2022). Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Medicine, 19(4), 1–25. https://doi.org/10.1371/journal.pmed.1003954
García-Martínez, P., Ballester-Arnal, R., Gandhi-Morar, K., Castro-Calvo, J., Gea-Caballero, V., Juárez-Vela, R., Saus-Ortega, C., Montejano-Lozoya, R., Sosa-Palanca, E. M., Gómez-Romero, M. D. R., & Collado-Boira, E. (2021). Perceived stress in relation to quality of life and resilience in patients with advanced chronic kidney disease undergoing hemodialysis. International Journal of Environmental Research and Public Health, 18(2), 1–10. https://doi.org/10.3390/ijerph18020536
Gebrie, M. H., Asfaw, H. M., Bilchut, W. H., Lindgren, H., & Wettergren, L. (2022). Psychometric properties of the kidney disease quality of life-36 (KDQOL-36) in Ethiopian patients undergoing hemodialysis. Health and Quality of Life Outcomes, 20(1), 1–10. https://doi.org/10.1186/s12955-022-01932-y
Ghasemi Bahraseman, Z., Mangolian Shahrbabaki, P., & Nouhi, E. (2021). The impact of stress management training on stress-related coping strategies and self-efficacy in hemodialysis patients: a randomized controlled clinical trial. BMC Psychology, 9(1), 1–9. https://doi.org/10.1186/s40359-021-00678-4
Ghazi, L., Osypuk, T. L., MacLehose, R. F., Luepker, R. V., & Drawz, P. E. (2021). Neighborhood Socioeconomic Status, Health Insurance, and CKD Prevalence: Findings From a Large Health Care System. Kidney Medicine, 3(4), 555-564.e1. https://doi.org/10.1016/j.xkme.2021.03.008
Helou, N., Talhouedec, D., Zumstein-Shaha, M., & Zanchi, A. (2020). A multidisciplinary approach for improving quality of life and self-management in diabetic kidney disease: A crossover study. Journal of Clinical Medicine, 9(7), 1–14. https://doi.org/10.3390/jcm9072160
International Society of Nephrology. (2023). Global Kidney Health Atlas. In ISN: Internacional Society of Nephrology.
Keivan, S., Shariati, A., Miladinia, M., & Haghighizadeh, M. H. (2023). Role of self-management program based on 5A nursing model in quality of life among patients undergoing hemodialysis: a Randomized Clinical Trial. BMC Nephrology, 24(1), 1–8. https://doi.org/10.1186/s12882-023-03108-2
Kidney Disease Improving Global Outcame. (2023). Clinical practice guideline for evaluation and manegement of chronic disease. Kidney International Supplements, July.
Kreibich, A., Hennecke, M., & Brandstätter, V. (2020). The Effect of Self-awareness on the Identification of Goal-related Obstacles. European Journal of Personality, 34(2), 215–233. https://doi.org/10.1002/per.2234
Krishnan, A., Teixeira-Pinto, A., Lim, W. H., Howard, K., Chapman, J. R., Castells, A., Roger, S. D., Bourke, M. J., Macaskill, P., Williams, G., Lok, C. E., Diekmann, F., Cross, N., Sen, S., Allen, R. D. M., Chadban, S. J., Pollock, C. A., Turner, R., Tong, A., … Craig, J. C. (2020). Health-Related Quality of Life in People Across the Spectrum of CKD. Kidney International Reports, 5(12), 2264–2274. https://doi.org/10.1016/j.ekir.2020.09.028
Lai, P. C., Wu, S. F. V., Alizargar, J., Pranata, S., Tsai, J. M., & Hsieh, N. C. (2021). Factors influencing self-efficacy and self-management among patients with pre-end-stage renal disease (Pre-esrd). Healthcare (Switzerland), 9(3), 1–12. https://doi.org/10.3390/healthcare9030266
Lestarisa, T., Hakim, S. R. L., Arifin, S., Carmelita4, A. B., & Widiarti, A. (2023). Correlation Between Duration of Hemodialysis and Quality of Life of Chronic Kidney Disease Patients Undergoing Hemodialysis in Dr . Doris Sylvanus Regional Public Hospital Palangka ... Advance Research Journal of Multidisciplinary Discoveries (ARJMD), 78(1), 1.
Lin, C. C., & Hwang, S. J. (2020). Patient-centered self-management in patients with chronic kidney disease: Challenges and implications. International Journal of Environmental Research and Public Health, 17(24), 1–13. https://doi.org/10.3390/ijerph17249443
Naseef, H. H., Haj Ali, N., Arafat, A., Khraishi, S., AbuKhalil, A. D., Al-Shami, N., Ladadweh, H., Alsheikh, M., Rabba, A. K., Asmar, I. T., & Sahoury, Y. (2023). Quality of Life of Palestinian Patients on Hemodialysis: Cross-Sectional Observational Study. The Scientific World Journal, 2023, 1–8. https://doi.org/10.1155/2023/4898202
Nilsen, F. A., Bang, H., Boe, O., Martinsen, Ø. L., Lang-Ree, O. C., & Røysamb, E. (2020). The Multidimensional Self-Control Scale (MSCS): Development and validation. Psychological Assessment, 32(11), 1057–1074. https://doi.org/10.1037/pas0000950
Nirat, A. D., Raghunath, D., Rai, S., Dixit, S., & Doharey, S. (2024). Assess The Knowledge , Perception , Level Of Satisfaction And Quality Of Life Of Beneficiaries Utilising Services Of Pradhan Mantri National Dialysis Program ( PMNDP ). 14(1). https://doi.org/10.5530/ijmedph.2024.1.24
Oh, T. R., Choi, H. S., Kim, C. S., Bae, E. H., Oh, Y. K., Kim, Y. S., Choi, K. H., Kim, S. W., & Ma, S. K. (2019). Association between health related quality of life and progression of chronic kidney disease. Scientific Reports, 9(1), 1–9. https://doi.org/10.1038/s41598-019-56102-w
Ouyang, W. wei, Chen, H. fen, Xu, X. yi, Zhang, X. long, Fu, L. zhe, Tang, F., Wen, Z. huai, Marrone, G., Liu, L. chang, Lin, J. xia, Liu, X. sheng, & Wu, Y. fan. (2022). Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study. BMC Nephrology, 23(1), 1–11. https://doi.org/10.1186/s12882-022-02700-2
Pauly, M., Mateti, U. V., Shenoy, P., Saj, N., & Philip, M. L. (2020). Dimensions of quality of life in the different stages of chronic kidney disease patients – A cross-sectional study. Clinical Epidemiology and Global Health, 8(3), 797–801. https://doi.org/10.1016/j.cegh.2020.02.002
Ranabhat, K., Khanal, P., Mishra, S. R., Khanal, A., Tripathi, S., & Sigdel, M. R. (2020). Health related quality of life among end stage renal disease patients from low income country, Nepal: a cross sectional study using WHOQOL-BREF. 1–18.
Riegel, B., Jaarsma, T., Lee, C. S., & Strömberg, A. (2019). Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science, 42(3), 206–215. https://doi.org/10.1097/ANS.0000000000000237
Rosén, H., Ahlström, G., & Lexén, A. (2020). Psychometric properties of the WHOQOL-BREF among next of kin to older persons in nursing homes. Health and Quality of Life Outcomes, 18(1), 1–11. https://doi.org/10.1186/s12955-020-01345-9
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