• Prin Yoomuang Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
  • Pattama Suphannakul Faculty of Public Health, Naresuan University, Phitsanulok, Thailand




self-management behavior, chronic kidney disease, Creer’s self-management


This research examined factors predicting self-management behaviors of patients with chronic kidney disease (CKD) stage 3 in Suphanburi Province. A multi-stage sampling technique was used to recruit participants from 10 hospitals in 10 districts of Suphanburi Province. A total of 228 participants have been diagnosed with CKD stage 3. Data were collected using a questionnaire with an overall Cronbach’s alpha coefficient of 0.96. Data were analyzed using descriptive statistics and stepwise multiple regression at the significant level of 0.05. The results showed that the social support scores from medical personnel had high levels (52.20%). Meanwhile, the score of healthcare providers, village health volunteers, and families had low levels (76.80%, 98.20%, and 85.10%, respectively). For illness perception, perceived benefits, self-efficacy, and self-management behaviors of patients with CKD stage had high levels (62.30%, 92.10%, 95.60%, and 50.90%, respectively). Meanwhile, CKD knowledge had moderate levels of 58.30%. The strongest predictor of self-management behaviors in a patient with CKD stage 3 was social support from healthcare providers (Beta = 0.348, p-value < 0.001), followed by perceived benefits (Beta = 0.299, p-value < 0.001) and self-efficacy (Beta = 0.266, p-value < 0.001), respectively. These factors account for 42.70% of predicting self-management behaviors of a patient with CKD stage 3. In conclusion, healthcare providers should encourage the self-management behaviors of patients with stage 3 CKD by enhancing their perceived benefits and self-efficacy to modify behaviors in order to slow the progression of CKD.


Sundström J, Bodegard J, Bollmann A, et al. Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2·4 million patients from 11 countries: The CaReMe CKD study. Lancet Reg Health Eur 2022; 20:100438. doi: 10.1016/j.lanepe.2022.100438

Liyanage T, Toyama T, Hockham C, et al. Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Global Health 2022;7(1): e007525. DOI: 10.1136/bmjgh-2021-007525. PMID: 35078812; PMCID: PMC8796212.

Ingsathit A, Thakkinstian A, Chaiprasert A, et al. Thai-SEEK Group. Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study. Nephrol Dial Transplant 2010; 25(5):1567-75. doi: 10.1093/ndt/gfp669. Epub 2009 Dec 27. PMID: 20037182.

Centers for Disease Control and Prevention. National Chronic Kidney Disease Fact Sheet, 2017. Atlanta, GA:US Department of Health and Human Services, Centers for Disease Control and Prevention. 2017. Available from:https://www.cdc.gov/diabetes/pubs/pdf/kidney_factsheet.pdf. (Accessed 30 Sept 2022).

Kanjanabuch T, Takkavatakarn K. Global Dialysis Perspective: Thailand. Kidney360 2020; 1(7): 671-75; DOI: https://doi.org/10.34067/KID.0000762020

Honeycutt AA, Segel JE, Zhuo X, et al. Medical costs of CKD in Medicare population. JASN 2013; 24(9):1478-83.

Hoerger TJ, Simpson SA, Yarnoff BO, et al. The future burden of CKD in the United States: a simulation model for the CDC CKD Initiative. Am J Kidney Dis 2015; 65(3):403-11. doi: 10.1053/j.ajkd.2014.09.023. Epub 2014 Nov 5. PMID: 25468386.

National Health Security Office. Management of chronic renal failure patients: National Health Insurance Fund Management Manual 2016. Bangkok. Tanapress Publishers, 2015. (in Thai)

Health data center (Thailand). Service Plan for Chronic Kidney Disease 2018. Available from https://hdcservice.moph.go.th/hdc/reports/page.php?cat_id=e71a73a77b1474e3b71bccf727009ce./ (Accessed 30 Sept 2022).

Lee MC, Wu S-FV, Hsieh N-C., et al. Self-Management Programs on eGFR, Depression, and Quality of Life among Patients with Chronic Kidney Disease: A Meta-Analysis. Asian Nurs. Res 2016;10, 255-62.

Li R, Liang N, Bu F, Hesketh T. The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2020; 8(3):e17776. doi: 10.2196/17776. PMID: 32217503; PMCID: PMC7148553.

KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013; 3(1): 1-150.

Creer, TL. Self-management of chronic illness. In Boekaerts M, Printrich PR, Zeidner M, editors. Handbook of self-regulation. San Diego, CA: Academic Press; 2000; 601-29.

Creer TL, Holroyd KA. Self-management. In Baum A, McManus C, Newman S, Weinman J, West R, editors. Cambridge handbook of psychology, health, and behavior. Cambridge:Cambridge University Press; 1997; 255-8.

Bernard R. Fundamentals of biostatistics (5th ed.). Duxbery: Thomson learning. 2000: 308.

Tabachnick BG, Fidell LS. Using multivariate statistics. Boston, MA: Pearson. 2012.

Noviana CM, Zahra AN. Social support and self-management among end-stage renal disease patients undergoing hemodialysis in Indonesia. J Public Health Res 2021; 11(2):2733. doi: 10.4081/jphr.2021.2733. PMID: 35238191; PMCID: PMC8941312.

Chen YC, Chang LC, Liu CY, et al. The Roles of Social Support and Health Literacy in Self-Management Among Patients With Chronic Kidney Disease. J Nurs Scholarsh 2018; 50(3):265-275. doi: 10.1111/jnu.12377. Epub 2018 Mar 23. PMID: 29569423.

Karimy M, Koohestani HR, Araban M. The association between attitude, self-efficacy, and social support and adherence to diabetes self-care behavior. Diabetol Metab Syndr 2018; 10(86). https://doi.org/10.1186/s13098-018-0386-6

Gantagad T, Porntip Sareeso T. Self-management support for slow progression in patients with pre-dialysis chronic kidney disease: a systematic review and meta-analysis. J Health Res 2020; 14 (3): 157-168.

Artiwitchayanon A, Keeratiyutawong P, Duangpaeng S. Predictors of Self Management in Patients with Chronic Kidney Disease Undergoing Continuous Ambulatory Peritoneal Dialysis. Rama Nurs J 2015; 21(2):172-85. Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/32306 (Accessed 26 Oct 2022)

Koetsenruijter J, Eikelenboom NV, Lieshout JV, et al. Social support and self-management capabilities in diabetes patients: An international observational study. Patient Educ Couns 2016; 99(4):638-643. https://doi.org/10.1016/j.pec.2015.10.029.

Brew-Sam N, Chib A, Rossmann C. Differential influences of social support on app use for diabetes self-management – a mixed methods approach. BMC Med Inform Decis Mak 2020; 20(151). https://doi.org/10.1186/s12911-020-01173-3

Greaney ML, Puleo E, Sprunck-Harrild K, et al. Social Support for Changing Multiple Behaviors: Factors Associated With Seeking Support and the Impact of Offered Support. Health Educ Behav 2018; 45(2):198-206.

Garizábalo-Dávila CM, Rodríguez-Acelas AL, Mattiello R, and Cañon-Montañez W. Social Support Intervention for Self-Management of Type 2 Diabetes Mellitus: Study Protocol for a Randomized Controlled Trial. Open Access J. Clin. Trials 2021; 13:37-43. https://doi.org/10.2147/OAJCT.S314030

Charoenchang P, Kerdmuang S, Kalampakorn S. Public Health Professional Competency of Public Health Officers Working in Thai Primary Care Units. Nursing Journal of the Ministry of Public Health 2016, 26(1):40–51. (in Thai)

Wu SV, Hsieh NC, Lin LJ, et al. Prediction of self‐care behavior on the basis of knowledge about chronic kidney disease using self‐efficacy as a mediator. J Clin Nurs 2016; 25:2609-18.

Moktan S, Leelacharas S, Prapaipanich W. Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease. Rama Med J 2019; 42(2):38–48. https://doi.org/10.33165/rmj.2019.42.2.119901

Paypat S, Pakdevong N, and Binhosen V. The Association among Knowledge, Self-Efficacy and Self-Management Behaviors in Patients with Chronic Kidney Disease. APHEIT Journal of Nursing and Health 2021; 3(2): 22-36.

Mirmazhari R, Ghafourifard M, Sheikhalipour Z. Relationship between patient activation and self-efficacy among patients undergoing hemodialysis: a cross-sectional study. Ren Replace Ther 2022;8(40). https://doi.org/10.1186/s41100-022-00431-6

Yao J, Wang H, Yin X, Yin J, Guo X, Sun Q. The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLoS One 2019; 14(11): e0224869. doi: 10.1371/journal.pone.0224869. PMID: 31710631; PMCID: PMC6844544.

Xu J, Jin J, Cheng M, et al. Benefit of an Internet-Based Management System among Hemodialysis Patients at the Risk of Intradialytic Hypotension and Muscle Cramps: A Controlled before and after Study. Blood Purif 2021; 51:464-71.

Unaphak P, Rattanamanee K. The Correlation factors of self-care behaviors to prevent complications among patients with chronic kidney disease at Somdetphra phutthalertla Hospital in Samutsongkhram Province. PHJBUU 2015; 10(2):44-53. (in Thai)

Hu Y, Liu H, Wu J, et al. Factors influencing self-care behaviours of patients with type 2 diabetes in China based on the health belief model: a cross-sectional study. BMJ Open 2022; 12:e044369. doi: 10.1136/bmjopen-2020-044369

Harrison TG, Wick J, Ahmed SB, et al. Patients with Chronic Kidney Disease and Their Intent to Use Electronic Personal Health Records. Can. J. Kidney Health Dis 2015; 2:23 doi:10.1186/s40697-015-0058-5




How to Cite

Yoomuang, P., & Suphannakul, P. . (2023). FACTORS PREDICTING SELF-MANAGEMENT BEHAVIORS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 3 IN SUPHANBURI PROVINCE, THAILAND. Malaysian Journal of Public Health Medicine, 23(1), 272–278. https://doi.org/10.37268/mjphm/vol.23/no.1/art.1925