Abstract
BackgroundFollowing an implementation plan based on dynamic dialogue between researchers and clinicians, this study implemented an evidence-based patient education program (tested in an RCT) into routine care at a clinical transplant center. The aim of this study was to investigate renal recipients’ knowledge and self-efficacy during first year the after the intervention was provided in an everyday life setting.MethodsThe study has a longitudinal design. The sample consisted of 196 renal recipients. Measurement points were 5 days (baseline), 2 months (T1), 6 months (T2), and one-year post transplantation (T3). Outcome measures were post-transplant knowledge, self-efficacy, and self-perceived general health.ResultsNo statistically significant changes were found from baseline to T1, T2, and T3. Participants’ levels of knowledge and self-efficacy were high prior to the education program and did not change throughout the first year post transplantation.ConclusionRenal recipients self-efficacy and insight in post-transplant aspects seem to be more robust when admitted to the hospital for transplantation compared to baseline observations in the RCT study. This may explain why the implemented educational intervention did not lead to the same positive increase in outcome measures as in the RCT. This study supports that replicating clinical interventions in real-life settings may provide different results compared to results from RCT’s. In order to gain a complete picture of the impacts of an implemented intervention, it is vital also to evaluate results after implementing findings from RCT-studies into everyday practice.
Highlights
In recent years, considerable improvements have been made in the field of transplantation
The implementation at the transplant centre in the present study was based on viewing implementation as a bidirectional process that depends on dynamic dialogue and allows for local adjustments [24,25,26]
In conclusion, there are several possible explanations for why we did not observe the same changes in the implementation study as with the reference randomized controlled trial (RCT)
Summary
Considerable improvements have been made in the field of transplantation. Health-care professionals have shown increased interest in facilitating the implementation of research results from academic settings to clinical practice. Following an implementation plan based on dynamic dialogue between researchers and clinicians, this study implemented an evidence-based patient education program (tested in an RCT) into routine care at a clinical transplant center. Clinical Context and the Evidence-Based Patient Education Programme tested in the RCT study The study was conducted at the only transplant centre in Norway. It performs about 270 kidney transplants and employs approximately 100 nurses within a surgical unit, medical unit, and outpatient clinic. The main differences between conventional patient education used at the transplant centre and the evidence-based patient education programme were the emphasis on individual adaptation, the method of knowledge transfer, the later timing of the education program and the extended number of training sessions
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