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Learning Objective 1: Discuss the application of the Chronic Care Model for the implementation of group visits in chronic kidney disease.
Learning Objective 2: Describe strategies for implementing a group visit model in the chronic kidney disease population.
Subject Population: Twenty-eight Stage 4 chronic kidney disease (CKD) patients, drawn from an outpatient nephrology practice.
Instruments: CKD knowledge will be measured using the CKD Knowledge Instrument (Montoya 2010). Self-efficacy/self-management will be measured with the Self-Efficacy and Self-Management Behaviors in Patients with CKD tool (Curtin 2008). Physiological data will consist of blood pressure, weight, estimated glomerular filtration rate/creatinine, HgA1c, and lipid levels. Patient satisfaction will be measured with an adaptation of the General Practice Assessment Survey (Ramsey, 2000).
Procedure: Participants will be randomized to either the CKD group visit intervention or to usual nephrology care. The CKD group visit is based on Social Cognitive Theory and the Chronic Care Model. Group visits will consist of 5 monthly visits, with a cohort of approximately 14 patients. Elements of a usual nephrology visit, including a physical examination, are components of the group visit, in addition to an interactive discussion of CKD-related topics. Data will be collected from both groups at baseline, 6 months, and 9 months (CKD knowledge, self-efficacy/self-management, & physiological). Satisfaction will be evaluated at 9 months.
Research Design: A two-group, repeated measures experimental design is planned to determine the efficacy of nurse practitioner-facilitated CKD group visits (knowledge, self-efficacy/self-management, physiological, satisfaction).
2011 Biennial Convention
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