Abstract
BackgroundOptimal self-management in kidney transplant recipients is essential for patient and graft survival, reducing comorbidity and health care costs while improving the quality of life. However, there are few effective interventions aimed at providing self-management support after kidney transplantation.ObjectiveThis study aims to systematically develop a nurse-led, self-management (support) intervention for kidney transplant recipients.MethodsThe Intervention Mapping protocol was used to develop an intervention that incorporates kidney transplant recipients’ and nurses’ needs, and theories as well as evidence-based methods. The needs of recipients and nurses were assessed by reviewing the literature, conducting focus groups, individual interviews, and observations (step 1). Based on the needs assessment, Self-Regulation Theory, and the “5A’s” model, change objectives were formulated (step 2). Evidence-based methods to achieve these objectives were selected and subsequently translated into practical implementation strategies (step 3). Then, program materials and protocols were developed accordingly (step 4). The implementation to test the feasibility and acceptability was scheduled for 2015-2017 (step 5). The last step of Intervention Mapping, evaluation of the intervention, falls outside the scope of this paper (step 6).ResultsThe intervention was developed to optimize self-management (support) after kidney transplantation and targeted both kidney transplant recipients and nurse practitioners who delivered the intervention. The intervention was clustered into four 15-minute sessions that were combined with regular appointments at the outpatient clinic. Nurses received a training syllabus and were trained in communication techniques based on the principles of Solution-Focused Brief Therapy and Motivational Interviewing; this entailed guiding the patients to generate their own goals and solutions and focus on strengths and successes. Kidney transplant recipients were encouraged to assess self-management challenges using the Self-Management Web and subsequently develop specific goals, action plans, and pursuit skills to solve these challenges.ConclusionsThe Intervention Mapping protocol provided a rigorous framework to systematically develop a self-management intervention in which nurses and kidney transplant recipients’ needs, evidence-based methods, and theories were integrated.International Registered Report Identifier (IRRID)DERR1-10.2196/11856
Highlights
Kidney transplantation is the best option for end-stage renal decease
Self-management can be defined as the ability of an individual, in conjunction with family, community, and health care professionals, to manage symptoms, treatments, lifestyle changes, psychosocial, cultural, and spiritual consequences of health conditions to maintain a satisfactory quality of life [8]
This study aims to develop a nurse-led self-management support intervention in which the needs of kidney transplant recipients and nurse practitioner performance objectives (POs) (NP) as well as theory and evidence-based methods, are taken into account; to ensure that these components were incorporated, the Intervention Mapping (IM) protocol was used [25]
Summary
Kidney transplantation is the best option for end-stage renal decease. kidney transplant recipients need to adhere to a lifelong medication regimen, and optimal self-management is essential for patient and graft survival, reducing comorbidity and health care costs while improving the quality of life [1,2,3,4,5,6]; this has led to an increasing interest in optimizing patients’ self-management skills [7].Self-management can be defined as the ability of an individual, in conjunction with family, community, and health care professionals, to manage symptoms, treatments, lifestyle changes, psychosocial, cultural, and spiritual consequences of health conditions to maintain a satisfactory quality of life [8]. Kidney transplant recipients need to adhere to a lifelong medication regimen, and optimal self-management is essential for patient and graft survival, reducing comorbidity and health care costs while improving the quality of life [1,2,3,4,5,6]; this has led to an increasing interest in optimizing patients’ self-management skills [7]. Recipients report self-management tasks to be challenging, such as adhering to immunosuppressive medication, monitoring symptoms and managing side effects, lifestyle changes, and coping with psychological consequences [12], and report the need for improved self-management support from health care professionals [13,14,15,16]. There are few effective interventions aimed at providing self-management support after kidney transplantation
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