Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia.
Nutr Diet. 2019 Sep;76(4):399-406. doi: 10.1111/1747-0080.12548. Epub 2019 May 13.
Interventions to prevent excessive weight gain after liver transplant are needed. The purpose of the present study was to enhance a specialist post-transplant well-being program through knowledge exchange with end-users.
The study used an interactive process of knowledge exchange between researchers, clinicians and health system users. Data were collected as focus groups or telephone interviews and underwent applied thematic analysis.
There were 28 participants (age 24-68 years; 64% male). The results identified experiences that may influence decisions around health behaviours during the course of transplant recovery. Three over-arching themes were identified that impact on liver transplant recipients post-transplant health behaviours. These include (i) Finding a coping mechanism which highlighted the need to acknowledge the significant emotional burden of transplant prior to addressing long-term physical wellness; (ii) Back to Life encompassing the desire to return to employment and prioritise family, while co-ordinating the burden of ongoing medical monitoring and self-management and (iii) Tailored, Personalised Care with a preference for health care delivery by transplant specialists via a range of flexible eHealth modalities.
This person-centred process of knowledge exchange incorporated experiences of recipients into service design and identified life priorities most likely to influence health behaviours post-transplant. Patient co-creation of services has the potential to improve the integration of knowledge into health systems and future directions will require evaluation of effectiveness and sustainability of patient-centred multidisciplinary service development.
需要采取干预措施来预防肝移植后体重过度增加。本研究的目的是通过与终端用户进行知识交流来增强专科移植后健康计划。
该研究采用了研究人员、临床医生和卫生系统用户之间的互动知识交流过程。数据收集采用焦点小组或电话访谈的形式,并进行了应用主题分析。
共有 28 名参与者(年龄 24-68 岁;64%为男性)。结果确定了可能影响移植恢复过程中健康行为决策的经验。确定了三个总体主题,这些主题影响肝移植受者的移植后健康行为。这些主题包括:(i)寻找应对机制,强调在解决长期身体健康问题之前,需要认识到移植带来的巨大情感负担;(ii)回归生活,渴望重返工作岗位并优先考虑家庭,同时协调持续的医疗监测和自我管理的负担;(iii)量身定制的个性化护理,倾向于通过一系列灵活的电子健康模式由移植专家提供医疗服务。
这种以人为本的知识交流过程将受者的经验纳入服务设计,并确定了最有可能影响移植后健康行为的生活优先事项。患者共同创造服务有潜力改善知识在卫生系统中的整合,未来的方向将需要评估以患者为中心的多学科服务发展的有效性和可持续性。