Nurse-Facilitated Self-Management in Peritoneal Dialysis: A Cross-Sectional Study from Riyadh, Saudi Arabia

Background: Peritoneal dialysis (PD) depends on patients' self-management abilities, supported by nursing interventions that extend beyond technical skills to include psychosocial and educational domains. Evidence from Saudi Arabia on how these behaviors relate to clinical and quality-of-life outcomes remains limited. Aim: To assess self-management behaviors among adult PD patients, examine their associations with clinical and quality-of-life outcomes, and explore the mediating role of emotional well-being, with implications for nursing practice. Methods: A descriptive cross-sectional study was conducted among 158 adult PD patients at King Saud University-affiliated centers in Riyadh. Validated Arabic versions of the Chronic Illness Self-Management Scale and KDQOL-SF were administered. Clinical indicators were extracted from medical records. Data were analyzed using descriptive statistics, t-tests, multivariate linear regression, and mediation analysis. Results: Technical skills achieved the highest self-management scores (mean 3.78 ± 0.62), while emotional coping was lowest (mean 2.71 ± 0.69). Participants with higher self-management had fewer hospitalizations (0.9 ± 0.5 vs. 1.6 ± 0.8, p = 0.01), higher serum albumin (3.60 ± 0.56 vs. 3.44 ± 0.61 g/dL, p = 0.04), and better emotional well-being (60.1 ± 14.9 vs. 55.3 ± 12.4, p = 0.03) than their counterparts. Educational level (β = 0.208, p = 0.001) and emotional well-being (β = 0.197, p = 0.001) were independent predictors of self-management, with partial mediation by emotional well-being (indirect β = 0.062, p = 0.004). Conclusions/Clinical Implications: Optimizing nursing support for PD patients requires moving beyond technical instruction to address health literacy, emotional resilience, and culturally sensitive education. Nurse-led interventions integrating psychosocial support with skill-building may enhance self-management, reduce hospitalizations, and improve quality of life in PD populations.