An eHealth self-management intervention for adults with chronic kidney disease, My Kidneys My Health: a mixed-methods study

Abstract

Background: There is limited research of electronic tools for self-management for patients with chronic kidney disease (CKD). We sought to evaluate participant engagement, perceived self-efficacy and website usage in a preliminary evaluation of My Kidneys My Health, a patient-facing eHealth tool in Canada. Methods: We conducted an explanatory sequential mixed-methods study of adults with CKD who were not on kidney replacement therapy and who had access to My Kidneys My Health for 8 weeks. Outcomes included acceptance (measured by the Technology Acceptance Model), self-efficacy (measured by the Chronic Disease Self-Efficacy Scale [CDSES]) and website usage patterns (captured using Google Analytics). We analyzed participant interviews using qualitative content analysis. Results: Twenty-nine participants with CKD completed baseline questionnaires, of whom 22 completed end-of-study questionnaires; data saturation was achieved with 15 telephone interviews. Acceptance was high, with more than 70% of participants agreeing or strongly agreeing that the website was easy to use and useful. Of the 22 who completed end-of-study questionnaires, 18 (82%) indicated they would recommend its use to others and 16 (73%) stated they would use the website in the future. Average scores for website satisfaction and look and feel were 7.7 (standard deviation [SD] 2.0) and 8.2 (SD 2.0) out of 10, respectively. The CDSES indicated that participants gained an increase in CKD information. Interviewed participants reported that the website offered valuable information and interactive tools for patients with early or newly diagnosed CKD, or for those experiencing changes in health status. Popular website pages and interactive features included Food and Diet, What is CKD, My Question List and the Depression Screener. Interpretation: Participants indicated that the My Kidneys My Health website provided accessible content and tools that may improve self-efficacy and support in CKD self-management. Further evaluation of the website’s effectiveness in supporting self-management among a larger, more heterogenous population is warranted.

Addressing Cognitive Function and Psychological Well-Being in Chronic Kidney Disease: A Systematic Review on the Use of Technology-Based Interventions

“…There were no specific criteria met by all 13 studies. Nine of the 13 studies analyzed used true randomization for the assignment of participants to treatment groups [ 28 , 30 , 45 , 54 , 55 , 56 , 57 , 58 , 59 ], whereas the remaining 4 did not meet this criterion [ 22 , 24 , 31 , 32 ].…”

“…In four of the studies, allocation to treatment groups was concealed [ 28 , 45 , 58 , 59 ], with two of them evaluated as unclear in this category [ 54 , 55 ], whereas the remaining seven did not meet this criterion [ 22 , 24 , 30 , 31 , 32 , 56 , 57 ].…”

“…Regarding the treatment groups, in nine of the studies, these were similar at the baseline [ 28 , 30 , 45 , 54 , 55 , 56 , 57 , 58 , 59 ], whereas in the remaining four articles, this criterion was not met [ 22 , 24 , 31 , 32 ].…”

“…In four of the studies, participants were blind to treatment assignments [ 45 , 55 , 56 , 58 ], whereas in eight of them, this criterion was not met [ 22 , 24 , 28 , 31 , 32 , 54 , 57 , 59 ], and in one of them this criterion was unclear [ 30 ]. Furthermore, in 2 of the studies, those delivering treatment were blind to treatment assignment [ 28 , 58 ].…”

“…New digital technology can help address cognitive and psychological symptoms through the design of interventions that are viable for symptom management while also being accessible, safe, and interactive [ 31 , 32 ]. For instance, virtual reality (VR), a computer-simulated real or imagined 3D environment, which allows users to experience the sensation of being present in a different physical space [ 33 , 34 ] has been used in different medical settings, such as people diagnosed with dementia and mild cognitive impairment [ 35 , 36 , 37 , 38 ].…”