CNA576: Potential Barriers in Self-Management for Renal Patients

This report, submitted as part of a CNA576 assignment, explores the multifaceted barriers hindering self-management in renal patients. The author, a student, identifies and analyzes various challenges, including physical limitations, psychological distress (such as depression and low self-efficacy), cognitive barriers stemming from a lack of knowledge, and health literacy issues. Socioeconomic factors, such as the cost of care, and social and cultural influences, like family dynamics and traditional beliefs, are also examined as significant impediments. The report emphasizes the need for healthcare professionals to recognize these diverse barriers and implement tailored interventions to improve patient outcomes and promote effective self-care strategies for individuals with chronic kidney disease. The assignment is based on a teaching episode and seeks to improve the author's skills as a facilitator of learning.

Running head: POTENTIAL BARRIERS
POTENTIAL BARRIERS
Name of the student:
Name of the university:
Author note:

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Introduction:
Every healthcare professional have the duty to encourage self-management to every
patients suffering from chronic disorders. Self-management in the present generations should go
beyond the traditional knowledge-based patient education for including processes that help in
developing the patient problem solving skills as well as to improve self-efficacy. It should also
help in supporting of aplication of knowledge in the real life situation that are important for the
patients (Holden, Schubert and Mickelson 2015). Therefore, the patients should be educated not
only about the different ways by which self-management should be carried on but they should be
also taught about the importance of self-management for handling chronic ailment symptoms.
The presentation provided to the patient for teaching them about the ways of taking self-care for
chronic kidney diseases and open discussions that was carried on after the presentation helped
me in understanding some of the potential barriers that patients face in self-management. This
assignment would mainly be discussing on such potential barriers so that professionals become
aware of such barriers and accordingly take necessary interventions.
Physical barriers:
One of the barriers that were noticed among some of the patients suffering from chronic
kidney disorder is the physical barrier. They are seen to suffer from physical disability mainly
due to reduction in strength as well as sensation. Researchers have noted that patients with
chronic kidney ailments suffer from sleep problems, fatigue and weakness as well as decreased
mental sharpness (Chiauzzi, Rodarte and DasMahapatra, 2015). They suffer from swelling in the
feet and the ankles as well as from muscle twitches and cramps. All these make them tired and
suffer so much that they do not feel like taking initiatives for self-management. They suffer from

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poor quality lives and unless the professionals help the patients in tackling the symptoms with
effective interventions and pharmacologic treatments, it becomes difficult for them to develop
the enthusiasm to overcome the tiredness and undertake activities of self-management.
Psychological barriers:
Physiological barriers were also noticed when interacting with the patients regarding their
feelings about self-management. Major depression as well as emotional were the two most
psychological challenges that affect self-care management of the patients suffering from chronic
ailments. Researchers are of the opinion that while high level of distress as well as frustration
mainly act as impetus for someone to seek help, it also becomes the barrier for achieving
behavioral goals. Many of the patients state that they become frustrated from drinking water by
measuring the amount every time and it especially affects them when they are very thirsty but
cannot drink much water (Ehde et al. 2014). Their restricted lifestyles make them depressed, as
they cannot lead regular lifestyle like their fellow friends and others. Researchers are also of the
opinion that low elf-efficacy is another major psychological barrier for optimal self-care and
management.
Cognitive barriers
Cognitive barriers are one of the most important barriers that impeded the self-care and
management strategies. Many researchers are of the opinion that the knowledge of the patient
about the specific chronic condition has a powerful influence on his or her ability of performing
optimal self-care. For example, it is seen that people with such chronic conditions might not
understand why the disorder took place, the working of the different medications that were
allocated for the patients, unable to understand the different signs and symptoms of worsening

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condition and many others. Lack of knowledge about the disorder and understanding of the diet
plan were other barriers (Miller, Cafazzo and Seto 2016). Patients do not understand the
importance of the self-care management and the negative outcomes it might affect on their
health. Therefore, they do not feel the need of undertaking self-care management.
Health literacy
Health literacy is another barrier that might also impeded self-care and management of
the persons suffering from chronic kidney problems. This mainly helps in including the ability of
patients in making decisions. These allow the patient in applying new information for navigating
the healthcare system successfully. Researchers are of the opinion that low health literacy is one
of the most important barriers in active participation of care by the patients and hence
professionals should pay importance in helping the patient to overcome this barrier (Kim et al.
2016). Studies have suggested that people with low literacy levels have more difficulty in
learning of the different self-care skills. It has been also noticed there might be many patients
with language issues, poor memory as well as dementia. This would also prevent the patients
from learning as well as utilizing the newer set of skills (Aucker et al. 2015). Therefore,
professionals should be taking the responsibility of simplifying the care and tailoring the
education to the individual patients according to the individual abilities of the patient.
Socio-economic position
Anther barrier that I have recognized is the economic barriers. Socio-economic position
is seen to be a significant factor in the determination of health status. While discussing with the
patients, after the presentation, many of patients coming from poorer socio-economic
background are of the opinion that resources required for supporting proper self-care as well as

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access to continuing care can be very expensive. Many of the patients also stated that they were
also concerned about the adequacy of the health insurance for the different ongoing treatment as
well as monitoring (Aldridge et al. 2016). All this were stated by them to be the major challenge
for those required help with their chronic care of the kidney diseases.
Social and cultural barriers:
One of the interesting facts that I also observed was that social and cultural barriers also
acted as challenges for self-management of the patients. Through a detailed interaction with the
patients, I have seen that the involvement of the family members can either support or hinder the
self-care behaviors of the patients. Women were seen to be more integrated in the extended
family networks. They are mainly seen to live with people of other generations while men are
seen to rely mainly on their partners for their support (Kruse et al. 2015). Again, there remains
specific role for spirituality as well as participation in the community religion as well as cultural
practices like traditional healing. These different preconceived notions may also impede the self-
management attitude of each of the patients and can alter their behaviors accordingly.
From the advice discussion, it becomes clear that important aspects are present which
might affect the self-care management of the patients. These are physical barriers, psychological
barriers, health literacy behaviors, cognitive behaviors, economic behaviors as well as social and
cultural behaviors. The professionals should therefore realize them and accordingly take
interventions helping them to overcome challenges and undertake self-care effectively.

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References:
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“You get reminded you’re a sick person”: Personal data tracking and patients with multiple
chronic conditions. Journal of medical Internet research, 17(8).
Chiauzzi, E., Rodarte, C. and DasMahapatra, P., 2015. Patient-centered activity monitoring in
the self-management of chronic health conditions. BMC medicine, 13(1), p.77.
Ehde, D.M., Dillworth, T.M. and Turner, J.A., 2014. Cognitive-behavioral therapy for
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Holden, R.J., Schubert, C.C. and Mickelson, R.S., 2015. The patient work system: An analysis of
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Kim, K., Choi, J.S., Choi, E., Nieman, C.L., Joo, J.H., Lin, F.R., Gitlin, L.N. and Han, H.R.,
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Kruse, C.S., Argueta, D.A., Lopez, L. and Nair, A., 2015. Patient and provider attitudes toward
the use of patient portals for the management of chronic disease: a systematic review. Journal of
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Miller, A.S., Cafazzo, J.A. and Seto, E., 2016. A game plan: gamification design principles in
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