Related Experiment Video
Updated: Jul 25, 2025
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Impact of COVID-19 on Disease Self-management Among Patients With Advanced CKD: A Qualitative Study
Jia H Ng1,2, Candice Halinski1,2, Devika Nair3
1Donald and Barbara School of Medicine at Hofstra/Northwell.
Insights
The COVID-19 pandemic increased vulnerability and cautionary behaviors for patients with advanced chronic kidney disease (CKD) and their care partners. This study highlights the need for future interventions to support self-management during health crises.
Area of Science:
- Nephrology
- Public Health
- Psychology
Background:
- The COVID-19 pandemic significantly impacted healthcare access and health outcomes for patients with advanced chronic kidney disease (CKD) and their care partners.
- Limited research exists on how pandemic-related challenges affected self-management strategies in this population.
Purpose of the Study:
- To examine the effects of the COVID-19 pandemic on the self-management activities of patients with advanced CKD and their care partners.
- To understand the cognitive, emotional, and social factors influencing self-management during the pandemic using Leventhal's self-regulation model.
Main Methods:
- A qualitative study design was employed.
- Thematic analysis was used to analyze data from 42 participants, including patients with advanced CKD (stages 4-5, dialysis, transplant recipients) and their care partners.
Main Results:
- Patients with CKD developed themes of increased threat perception, heightened anxiety, coping through virtual interactions, and enhanced protective behaviors.
- Care partners exhibited hypervigilance, adapted to health system interactions, and intensified caregiving roles.
- Key themes indicate increased vulnerability and cautionary actions among patients and care partners during the pandemic.
Conclusions:
- Patients with advanced CKD and their care partners adopted increased protective behaviors and experienced heightened vulnerability during the COVID-19 pandemic.
- Findings underscore the need for tailored interventions to support self-management for kidney disease patients and their care partners during future health crises.
Rationale & Objective:
Patients with advanced chronic kidney disease (CKD) and their care partners experienced decreased access to care, and worse physical and emotional health during the Coronavirus Disease-19 (COVID-19) pandemic. Few studies have explored how COVID-19-related challenges affected disease self-management among those with advanced chronic kidney disease (CKD) and their care partners. Leventhal's self-regulation model offers a comprehensive framework for understanding disease self-management through the interplay of cognitive beliefs, emotional reactions and social influences. The study aims to examine the impact of COVID-19 on self-management activities among patients with CKD and care partners.
Study Design:
Qualitative study.
Setting & Participants:
Adults with advanced CKD, including dialysis and transplant recipients, and their carepartners.
Analytical Approach:
Thematic Analysis.
Results:
Among 42 participants, 12 had stage 4 CKD, 5 had stage 5 CKD, 6 were receiving in-center hemodialysis, 5 had a kidney transplant, and 14 were care partners. We identified 4 patient-related themes with corresponding subthemes related to the impact of COVID-19 on self-management: 1) cognitive understanding that COVID-19 is an additional health threat to existing kidney disease, 2) heightened anxiety and vulnerability driven by perceived risk, 3) coping with isolation through virtual interactions with healthcare services and social circles, 4) increased protective behaviors to maximize survival. Three care partner-related themes emerged: 1) hypervigilance in family care and protection, 2) interaction with health system and adaptations to self-management, and 3) increased intensity in caregiving role to facilitate patient self-management.
Limitations:
The qualitative study design limits the ability to generate generalizable data. Grouping patients with Stage 3 and 4 CKD, in-center hemodialysis, and kidney transplants together limited our ability to examine self-management challenges specific to each treatment requirement.
Conclusions:
When faced with the COVID-19 pandemic, patients with CKD and their care partners experienced heightened vulnerability and thus increased cautionary activities to maximize survival. Our study provides the groundwork for future interventions to help patients and care partners live with kidney disease during future crises.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
01:18Chronic Kidney Disease IV: Nursing Management
01:25Chronic Kidney Disease I: Introduction
01:24Chronic Kidney Disease II: Clinical Manifestations
01:22Acute Kidney Injury VI: Nursing Management
01:16Kidney Transplant III: Nursing Management