الفهرس 
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Abstract
Chronic renal failure (CRF) is a pathologic process with numerous causes, resulting in a steady reduction in the number and function of nephrons, and leading to end-stage renal disease (ESRD) in many cases. An estimated 2•6 million people worldwide were treated for ESRD. Although hemodialysis is a therapeutic approach to ESRD, these people face many physical, psychological and stressful factors, which cannot be controlled even with new techniques (Zibaei et al., 2020).
Aim of the Study
To assess self- care management of chronic Renal Failure at Home through the following objectives:
- Assessing the knowledge of patients related to chronic renal failure.
- Assessing the reported practices of patients related to self care management of chronic renal failure.
-Assessing the home environment in relation to the need of patient with chronic renal failure.
Research Questions:
1- Is there relation between patients sociodemographic characteristic and their knowledge?
2- Is there relation between patients sociodemographic characteristic and their self care practices?
3- Is there relation between patients knowledge and their self care practices?
Study Design:
A descriptive design was used in this study.
Sample:
Convenient sample that included 160 Renal failure patients out of the total attending the previously mentioned setting At (2017-2018) according to the hospital statistics. Home visiting was done for 50% of patients.
Tools of Data Collection:
Two tools was used for data collection.
First tool: Self –administered questionnaire for patients: composed of four parts including:
Part I: Demographic characteristics of chronic renal Failure patients It included: (Age, Gender, Marital status, Having children, level of education, Occupation, Monthly income, Type of housing, No. of rooms, Family size, Crowding index).
Part II: medical history of CRF patients It included: (The onset of disease, presence of other chronic diseases, Method of diagnosing renal failure, Current complain related to the disease, Family history of kidney failure, Beginning of hemodialysis, Schedule of hemodialysis system, Method of hemodialysis) .
Part III: patients’ Knowledge related to CRF disease It included:(Meaning, Causes, Symptoms, Diagnostic Measures, Types of CRF, Complications, Treatment & prevention of CRF,(source of information )This question was excluded from the scoring system: (Q 20: Q 27) ?
Part IV: patients, reported practices regarding self care management at home including compliance of treatment & follow up it included: (The family communicate with the medical team, Ability of patient to take care of himself as a result of illness, Commitment to the dates of dialysis sessions, Commitment to the specified session duration, Commitment to withdraw excess weight during the session, Follow-up a proper dry weight, Adherence to the medical treatment as prescribed, Adherence to the diet, Commitment to monthly analysis and follow-up with the doctor, Get vaccinations such as influenza and HVB, Commitment to information obtained from health education).
Second tool:
Self–care management For chronic Renal Failure Assessment sheet was adopted from (Robert et al., 2011) & was modified by investigator to meet the aim of the study. It included: 5 parts:
Part 1: Health maintenance skills and physical functioning activities of daily living regarding: Self-care practices related to Nutrition, Sleep, physical exercise, daily activity, and fistula care.
Part 2: Self-care practices related to Psychological and spiritual attitudes.
Part 3: Self-care practices related to Social involvement.
Part 4: Self-care practices related to self –actualization style.
Part 5: Home environment It included: General condition related to housing, Lighting, Bath room, Kitchen, Ventilation, Water, Sewage system, Garbage, Cleaning.
Results:
The most important results obtained from this study can be summarized as follows:
- It was found that 39.4% of patients belong to the age group above 60 years, with a mean of 10.79 ± 56.13.
- It was found that 50.6% of patients are male.
- It was found that 61,3% of patients could neither read nor write.
- It was found that 38,1% of patients were married.
- It was found that 65,6% of patients were without work.
- It was found that 72,5% of patients do not have enough income.
- It was also observed that 51,9% of patients had average kidney information
- It was also noted that 85% of patients had a source of information from the medical team.
- It was also noted that 83,1% of patients had total self-care practices they were doing.
- It was found that 57,5% of patients had their total self-care practices were inadequate.
- It was found that 79.4% of patients with chronic renal failure are safe around the whole home environment.
- It was noted that there is a correlation between socio-demographic characteristics and their information about the disease.
- It also notes the existence of a positive correlation with statistical significance between the socio-demographic characteristics and their practice of the disease.
- It also notes that there is no statistical correlation between patients’ information and their practices towards the disease.
Conclusion:
Based on the findings and research questions, the study was concluded that more than half had average knowledge score and more than half had a adequate self care practices, there was highly statistically significant difference (p-value = 0.000) between age, marital Status and a total knowledge.
While their practices there was highly statistically significant difference related to age, level of education, occupation and monthly income and their self care practices with (p-value = 0.000).
Regarding the statistical relation between knowledge and self care practices of the patients there were no significant difference.
Recommendation:
1- Organize regular counseling sessions out patients, nephrology clinics for meeting the patients’ needs and solving their problems by providing them with clear, full and accurate information about self care.
2- A simple manual of guidelines of care for patients undergoing hemodialysis should be available in all units to be provided to newly admitted patients.
3- A simple manual of guidelines of care for patients undergoing hemodialysis should be available in all units to be provided to newly admitted patients.
4- Future researches: Are advised to conduct research with a larger sample size from different hospitals as well as from different geographical area in Egypt to enhance the meticulousness of the research design and further verify the effects of a self-management program on patients with CKD.