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A new self-management engagement scale for haemodialysis patients (PRIESM CKD-HD): development and validation

Helen Munro Wild1, David Wellsted1, Andrew Davenport2

  • 1Department of Psychology, Sport and Geography, School of Health, Medicine and Life Sciences, University of Hertfordshire, Hertfordshire, UK.

Clinical Kidney Journal
|May 7, 2026
PubMed

Insights

The Patient Reported Instrument for Engagement in Self-Management for people with Chronic Kidney Disease, receiving Haemodialysis (PRIESM CKD-HD) is a new, valid, and reliable tool. It measures patient engagement in self-management, offering a patient-centered perspective for better support.

Area of Science:

  • Nephrology
  • Psychology
  • Health Services Research

Background:

  • Self-management requires clearer definition in kidney research and practice.
  • Current measures focus heavily on dialysis tasks and adherence.
  • The Patient Reported Instrument for Engagement in Self-Management for people with Chronic Kidney Disease, receiving Haemodialysis (PRIESM CKD-HD) addresses this gap.

Purpose of the Study:

  • To develop and validate a patient-reported measure of self-management engagement for individuals undergoing haemodialysis (HD).
  • To incorporate a biopsychosocial model, capturing daily management, impact, communication, and clinical care aspects.
  • To provide a tool for identifying support needs and fostering discussion on targeted interventions.

Main Methods:

  • Sequential mixed-methods approach including literature review, qualitative interviews (n=27), expert consensus (n=19), and cognitive testing (n=11).
  • Large-scale survey (n=363) across three kidney centers for validation, with subgroup follow-up (n=95).
  • Exploratory factor analysis and correlation analyses with depression and self-efficacy measures.

Main Results:

  • PRIESM CKD-HD demonstrated good validity and reliability, with an overall Cronbach's alpha of 0.92.
  • Exploratory factor analysis supported a three-factor model: daily managing and impact (α=0.91), communication (α=0.84), and clinical care (α=0.66).
  • Strong correlations with depression (r=-0.74) and self-efficacy (r=0.75) supported construct validity. Test-retest reliability was high (r=0.84).

Conclusions:

  • PRIESM CKD-HD is the first measure to capture self-management from the patient's perspective, including psychosocial elements for haemodialysis patients.
  • The findings challenge the notion that some individuals do not wish to self-manage.
  • This instrument can guide tailored support strategies for chronic kidney disease patients on haemodialysis.
Abstract

Keywords:
chronic kidney disease patient reported outcome measure (CKD PROM)haemodialysispsychosocialscale developmentself-management

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