Abstract
Background: Self-management should be better defined within kidney research and clinical practice. A focus on dialysis related tasks and adherence continues to be central to current measures. PRIESM CKD-HD aligns with a biopsychosocial model and measures engagement in self-management by people receiving haemodialysis (HD). This provides the opportunity to identify gaps and foster discussion about targeted support.
Methods: Scale development was undertaken using a sequential mixed-methods approach, comprising literature review, qualitative interviews with HD patients (n=27), expert consensus (n=19) and cognitive testing (n=11). A large-scale survey (n=363) across three kidney centres was conducted to validate the scale, with sub-group follow up 4-6 weeks later. Exploratory factor analyses were conducted to assess model fit, reliability, and validity.
Results: PRIESM CKD-HD is a valid and reliable measurement. Exploratory factor analysis indicated a three-factor model consisting of daily managing and impact (α = .91), communication (α = .84), and clinical care (α = .66). Model statistics, X2 = 703, 296 df, p < 0.001, CFI=0.87, TLI = 0.86, RMSEA = 0.07, SRMR = 0.07, overall α = 0.92. Correlation with measures of depression (r (328) = -.74, p<0.001) and self-efficacy (r (337) = .75, p<0.001) provided further evidence of validity. Test re-test reliability r=0.84, p<0.001, indicates good linear agreement over time (n=95).
Conclusions: PRIESM CKD-HD is the first measure of self-management that reframes the concept from the patient perspective and incorporates the psychosocial aspects of treatment impact and daily managing for haemodialysis patients. Findings suggest the perception that not all individuals wish to self-manage should be refuted.
Methods: Scale development was undertaken using a sequential mixed-methods approach, comprising literature review, qualitative interviews with HD patients (n=27), expert consensus (n=19) and cognitive testing (n=11). A large-scale survey (n=363) across three kidney centres was conducted to validate the scale, with sub-group follow up 4-6 weeks later. Exploratory factor analyses were conducted to assess model fit, reliability, and validity.
Results: PRIESM CKD-HD is a valid and reliable measurement. Exploratory factor analysis indicated a three-factor model consisting of daily managing and impact (α = .91), communication (α = .84), and clinical care (α = .66). Model statistics, X2 = 703, 296 df, p < 0.001, CFI=0.87, TLI = 0.86, RMSEA = 0.07, SRMR = 0.07, overall α = 0.92. Correlation with measures of depression (r (328) = -.74, p<0.001) and self-efficacy (r (337) = .75, p<0.001) provided further evidence of validity. Test re-test reliability r=0.84, p<0.001, indicates good linear agreement over time (n=95).
Conclusions: PRIESM CKD-HD is the first measure of self-management that reframes the concept from the patient perspective and incorporates the psychosocial aspects of treatment impact and daily managing for haemodialysis patients. Findings suggest the perception that not all individuals wish to self-manage should be refuted.
| Original language | English |
|---|---|
| Journal | Clinical Kidney Journal |
| DOIs | |
| Publication status | Accepted/In press - 3 Dec 2025 |
Keywords
- Chronic Kidney Disease Patient Reported Outcome Measure (CKD PROM)
- Haemodialysis
- Psychosocial
- Scale development
- Self-Management