Chronic kidney disease (CKD) is a global public health problem with increasing incidence, prevalence and mortality rates [1, 2]. The global prevalence of all stages of CKD was 9.1% [1]. According to the World Health Organization report, there will be a projected increase of 14% in the mortality rate related to CKD by 2030, accounting for 11.5 million deaths globally [3]. In Saudi Arabia, CKD is the fourth leading cause of death [4]. In recent decades, the number of people who have initiated renal replacement therapy in Saudi Arabia has been increasing rapidly, with a 7.7% annual growth rate of the population on dialysis [5].
CKD can progress to end-stage kidney disease (ESKD) and cause other complications that require dialysis or kidney transplantation [6, 7]. Hemodialysis is the most common treatment option used worldwide for the management of ESKD, followed by peritoneal dialysis [8]. Patients undergoing dialysis may experience adverse events, which can have devastating and costly impacts on patient quality of life and healthcare systems [9, 10]. Due to the chronic nature of the disease, CKD requires continuous monitoring and care. All healthcare professionals, especially nurses, play key roles in providing care and education to patients and need to empower patients to be actively engaged in the self-management of their disease.
CKD management mainly depends upon the patient's self-management skills, which include the ability to implement lifestyle modifications and cope with symptoms, medications, and the physical and psychosocial side effects of having CKD and related comorbidities [11]. Patient self-management has five dimensions: communication, partnership in care, self-care activities, self-integration, and adherence to the recommended treatment [11, 12].
Perceived disease-related self-efficacy (DSE) is a fundamental component of the effective self-management of chronic diseases [11, 13, 14]. It is conceptualized as patients’ confidence in their ability to overcome barriers and achieve the desired outcomes [15, 16]. According to self-efficacy theory, if individuals believe that they can achieve a result, they will be a more active participant in the management of their condition, which will facilitate adequate disease control [15]. Studies have shown that self-efficacy is a predictor of health behavior improvements, such as adherence to the recommended treatment, communication, problem solving and social support, among chronic disease patients in general [12, 17, 18].
Self-efficacy plays a vital role in delaying CKD progression, and it has been shown that a higher level of self-efficacy in CKD patients is associated with better quality of life [11, 19] and lower levels of anxiety and depression [20]. However, there are many factors that could influence CKD patients’ behavior, such as age, sex, type of dialysis, and duration of dialysis [13].
The prevalence of CKD has increased, imposing a burden on the global health care system, and different studies have been shown a positive association between perceived self-efficacy and health care utilization among the CKD population [13, 14, 21]. Knowing the level of self-efficacy among the CKD population is essential to providing appropriate interventions that promote self-competence with regard to controlling disease progression. In Saudi Arabia, this is the first study to evaluate CKD patients’ self-efficacy and determine the associated factors among dialysis patients.