Associations of BCW-informed early rehabilitation nursing with patient compliance and related outcomes in non-dialysis chronic kidney disease patients

Abstract

To examine the association between a BCW-informed intensive nursing support package and patient compliance and related outcomes in non-dialysis patients with chronic kidney disease (CKD). This retrospective, non-randomized observational study analyzed the clinical and nursing records of 57 non-dialysis CKD patients admitted to our hospital from June 2022 to June 2023. All patients met the predefined inclusion and exclusion criteria. Patients were retrospectively classified according to the nursing intervention documented in their clinical records: 27 patients who received routine nursing were included in the control group, and 30 patients who received a BCW-informed intensive nursing support package were included in the observation group. Outcomes included nutrition-related indicators [albumin (ALB), prealbumin (PA), transferrin (TF), and body mass index (BMI)], renal function-related indicators [blood urea nitrogen (BUN), serum creatinine (Scr), and cystatin C (CysC)], self-reported dietary adherence assessed using an adapted Renal Adherence Behavior Questionnaire (RABQ), quality of life, and reported nursing satisfaction. Before the intervention, there were no significant differences between the two groups in nutrition-related indicators, renal function-related indicators, RABQ scores, or quality of life (all p  > 0.05). After the intervention, the observation group showed significantly higher ALB, PA, and BMI levels than the control group ( p  < 0.05), whereas the between-group difference in TF was not statistically significant ( p  = 0.169). For renal function-related indicators, BUN was significantly higher and CysC was significantly lower in the observation group than in the control group ( p  < 0.05), whereas Scr was numerically higher but the between-group difference did not reach statistical significance ( p  = 0.054), indicating inconsistent changes among renal function-related markers. After the intervention, the observation group also had higher adapted RABQ scores, indicating higher self-reported dietary adherence on this instrument, and higher quality-of-life scores than the control group ( p  < 0.05). The reported nursing satisfaction rate was 77.78% in the control group and 100.00% in the observation group. In this retrospective, non-randomized study, the BCW-informed intensive nursing support package was associated with more favorable nutrition-related indicators, higher self-reported dietary adherence scores on the adapted RABQ, better quality-of-life scores, and higher reported nursing satisfaction. Renal function-related indicators were inconsistent, and because the observation group received greater nursing contact, the specific effect of BCW/COM-B cannot be distinguished from nonspecific attention or intervention-dose effects.