Effects of Targeted Interventions on Lifestyle Modifications of Chronic Kidney Disease Patients

Abstract

Targeting interventions to an individual's readiness to modify lifestyle factors, specifically diet and exercise behaviors, may delay chronic kidney disease (CKD) progression. This study examined the effects of a targeted Lifestyle Modification Program based on the readiness to change health-promotion lifestyle behaviors, renal protection knowledge, and physical indicators of patients with early CKD. A repeated-measures design randomized 160 CKD patients from four southern Taiwan outpatient nephrology clinics into control and intervention groups. Data were collected five times over a year with a participant retention rate of 64.4%. The intervention group demonstrated significant improvement with regard to diet behavior modifications. Compared with the control group, the intervention group showed a significant improving trend of renal function protection knowledge, stress management, and interpersonal relations. Targeted interventions for patients in the early phases of CKD promotes adherence to proper diet, exercise behavior, and positive lifestyle modifications.

Lifestyle behaviour change for preventing the progression of chronic kidney disease: a systematic review

“…Five studies were informed by theory, three used the Trans-Theoretical Model,30 31 one used self-regulation theory32 and another was informed by contemporary behavioural theory, in particular the self-management approach 33. Two studies used Motivational Interviewing,34 35 a counselling approach which involves behaviour change strategies 36…”

“…Only three studies included family members, friends or partners in the intervention to facilitate participant’s behaviour change (online supplementary table S2). 31 37…”

“…Eighteen (69%) interventions used enablement. Examples include Motivational Interviewing to improve self-management of diet, lifestyle and physical activity,32 43 supportive telephone calls matching stages of behaviour change,30 self-management techniques to foster self-efficacy38 39 44 and arranging support from friends and family members and ‘buddy’ visits 31 33. Four interventions were specifically designed using a self-management approach and assessed self-efficacy as an outcome 32 33 39 44…”

“…In another dietary intervention, positive thinking was applied to participant’s goals and dieticians praised progress and focused on positive results 33. Similarly, a lifestyle intervention used positive reinforcement to increase confidence and celebrate successes related to behaviour change and also discussed lack of exercise, poor dietary habits, risks of not exercising and associated consequences 31. Only one physical activity intervention used persuasion in designing and displaying printed health messages to promote exercise 30…”

“…Primary outcomes of studies in this review were diverse and were mainly physiological metrics (for example, eGFR, blood pressure, peak VO 2 and sodium or albumin excretion). Only six studies included patient-reported and/or behavioural primary outcomes such as quality of life, fatigue, knowledge, self-efficacy, self-management, exercise and health behaviours 30 31 44 45 48 49…”