Zihao Song,1,* Yuping Xiao,2,* Yanjin Su,3 Gangxin Qin,3 Jinxin Yang4 

1Department of Clinical Medicine of Traditional Chinese and Western Medicine, The First Clinical Medical College of Shaanxi University of Chinese Medicine, Xianyang, People’s Republic of China; 2School of Nursing, Shaanxi University of Traditional Chinese Medicine, Xianyang, People’s Republic of China; 3First Department of Endocrinology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People’s Republic of China; 4Department of Hemodialysis, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Gangxin Qin, First Department of Endocrinology, Affiliated Hospital of Shaanxi University of Chinese Medicine, No. 2 (Subsidiary), Weiyang West Road, Qindu District, Xianyang, People’s Republic of China, Tel +86-15029300325, Email 1057768590@qq.com Jinxin Yang, Department of Hemodialysis, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, No. 5, Weiyang West Road, Xianyang, People’s Republic of China, Tel +86-18292921579, Email 398920188@qq.com

Purpose: Self-management among diabetic kidney disease(DKD) patients receiving home peritoneal dialysis(PD) remains a significant challenge, warranting further exploration. In this study, the Theory of Planned Behavior (TPB) was used to clarify patients’ decision-making processes and understand the reasons for adhering to and changing behaviors.
Methods: Semi-structured interviews were conducted with 16 DKD patients who were undergoing follow-up and receiving home PD. The TPB was applied to formulate the interview themes and provide information for the Interpretative Phenomenological Analysis (IPA) method used.
Results: A total of 3 themes and 7 sub-themes were summarized, namely attitude towards behavior, where physical and mental perception affects the decision-making attitude (the positive feedback of improved physical function strengthens the decision-making attitude; the two-way influence of emotions catalyzes the decision-making attitude); subjective norm, where social factors drive the decision-making belief (the behavioral outcomes of peers transform the decision-making belief; the continuity of medical and nursing services consolidates the decision-making belief; the motivation of social feedback stimulates the decision-making belief); perceived behavioral control, where self-perception influences the decision-making intention (positive self-efficacy motivates the decision-making intention; the limitation of external resources restricts the decision-making intention).
Conclusion: For the management of home PD in patients with DKD, efforts can be made to improve patients’ decision-making in self-management of home PD by strengthening the positive feedback of psychological experiences in behavioral decision-making, exploring digital peer support platforms and social support networks for such patients to improve the mechanism of patients’ active participation in decision-making within social support networks, and improving the community support system from multiple dimensions such as incorporating relevant policies into assessment criteria, coordinating funds through multiple channels, enhancing the capabilities of community medical and nursing teams, and encouraging doctor-patient shared decision-making, thereby exploring and constructing a community assistance model for the management of home PD in patients with DKD.

Keywords: diabetic kidney disease, home peritoneal dialysis, Self-management, theory of planned behavior, qualitative research