Network analysis of negative emotion and self-management in Chinese patients with early chronic kidney disease

The number of patients with chronic kidney disease (CKD) is increasing worldwide, and the disease carries a serious physical and psychological burden that creates negative emotions among patients. The negative emotions limits patients' ability to manage their disease and prevents them from effectively delaying disease progression. In this study, we applied a network analysis to explore the network relationship between negative emotions and self-management in patients with CKD and to investigate the risk or protective effects of different components of negative emotions on self-management. The study was conducted from September 2021 to March 2022 in three tertiary hospitals in China, with data gathered via a convenience sampling method. 360 patients with CKD at stages 1 similar to 3 in the department of nephrology completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale and Chronic Kidney Disease Self-management Instrument. We used R4.1.1 software to estimate the network model and calculate the related indicators. The network showed that among negative emotions "irritated" was negatively correlated with "self-integration", "problem solving", "seeking social support" and "adherence to recommended regimen" in self-management. The correlations between "scared" and "self-integration", "nervous" and "problem solving", and "ashamed" and "seeking social support" were all positive. The bridge expected influence of "irritated" and "adherence to recommended regimen" were the highest, with values of -0.19 and 0.13, respectively. "Irritated" has a more obvious risk effect on self-management. This study provides an important target for interventions to reduce negative emotions and improve self-management ability in patients with CKD.