Self-efficacy in patients undergoing home dialysis: An integrative review

Author Identifier

Nicola D'SOUZA

Date of Award


Document Type

Thesis - ECU Access Only


Edith Cowan University

Degree Name

Master of Nursing (Research)


School of Nursing and Midwifery

First Supervisor

Ma’en Zaid Abu-Qamar

Second Supervisor

Lisa Whitehead


Objective: The objective of this integrative review was to synthesise evidence on perceived self-efficacy among patients receiving home dialysis. The review also aimed to identify measures utilised and interventions employed to assess and improve self-efficacy.

Research problem: Home dialysis requires a multidimensional approach that is associated with adherence to dialysis regimes, fluid management, dietary restrictions and medications. Effective self-care strategies involve lifelong behavioural changes and adherence with treatment regimens that can create challenges and a sense of burden among patients, their families or caregivers. With a growing body of evidence linking improved health outcomes to high self-efficacy, it is imperative to understand self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in this population.

Inclusion criteria: This review considered research studies reporting on perceived self-efficacy, measures of self-efficacy, and interventions to enhance self-efficacy in patients on home dialysis. Studies that focused on self-efficacy of patients undergoing in-centre dialysis and pre-dialysis were excluded.

Methods: An integrative review was employed using Whittemore and Knafl’s (2005) methodology. CINAHL, MEDLINE, Embase and Scopus databases were searched without a date limit for studies published in English. Fifteen studies met the inclusion criteria and were critically appraised by two independent reviewers using Joanna Briggs Institute critical appraisal tools. Narrative synthesis of the findings was conducted because meta-analysis was not possible owing to the heterogeneity of the findings.

Results: The included studies were predominantly quantitative studies (n = 10) examining training programs to promote self-efficacy and the report of levels of self-efficacy in patients on home dialysis. The majority of studies reported on peritoneal dialysis in the home setting (n = 649, 91.5%). Narrative synthesis led to the generation of two themes; gaining skills to develop self-efficacy; and building and maintaining knowledge. The findings highlight the importance of health professionals, families and peer support in developing self-efficacy. To advance research and Self-efficacy in patients undergoing home dialysis: An integrative review practice in this area, it is recommended to address the sociodemographic factors that influence self-efficacy and evaluate the long-term impact of interventions on self-efficacy.



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