Leicester Medical School, University of Leicester, Leicester, UK.
Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.
J Nephrol. 2022 Sep;35(7):1863-1872. doi: 10.1007/s40620-022-01325-w. Epub 2022 Apr 25.
Understanding the behaviours that facilitate or impede one's ability to self-manage is important to improve health-related outcomes in kidney transplant recipients (KTRs). Previous studies exploring the self-management experiences of KTRs have focused on specific tasks (e.g., medication adherence), age groups (e.g., adolescent or older recipients), or have been conducted outside of the UK where transferability of findings is unknown. Our study aimed to explore the perceptions and experiences of self-management in UK KTRs to identify facilitators and barriers associated with self-management tasks.
Semi-structured interviews were conducted with eleven KTRs. Topics explored included experiences of self-management tasks (diet, exercise, medications, stress management), perceived healthcare role, and future interventional approaches. Thematic analysis was used to identify and report themes.
Eight themes were identified which were mapped onto the three self-management tasks described by Corbin and Strauss: medical, role and emotional management. Perceived facilitators to self-management were: gathering health-related knowledge, building relationships with healthcare professionals, creating routines within daily life, setting goals and identifying motivators, establishing support networks, and support from family and friends. Complexity of required treatment and adjusting to a new health status were perceived barriers to self-management.
Participants described the importance of collaborative consultations and continuity of care. Tailored interventions should identify individualised goals and motivators for participating in self-management. Education on effective strategies to manage symptoms and comorbidities could help alleviate KTRs' perceived treatment burden. Family and peer support could emotionally support KTRs; however, managing the emotional burden of transplantation warrants more attention.
了解有助于或阻碍自身管理能力的行为对于改善肾移植受者（KTR）的健康相关结局至关重要。先前探索 KTR 自我管理经验的研究侧重于特定任务（例如，药物依从性）、年龄组（例如，青少年或老年受者），或者是在英国以外进行的，其研究结果的可转移性未知。我们的研究旨在探讨英国 KTR 自我管理的认知和经验，以确定与自我管理任务相关的促进因素和障碍。
对 11 名 KTR 进行了半结构化访谈。探讨的主题包括自我管理任务（饮食、锻炼、药物、压力管理）的经验、感知的医疗保健角色以及未来的干预方法。使用主题分析来识别和报告主题。
确定了 8 个主题，这些主题映射到 Corbin 和 Strauss 描述的三项自我管理任务上：医疗、角色和情绪管理。自我管理的感知促进因素包括：获取与健康相关的知识、与医疗保健专业人员建立关系、在日常生活中创建常规、设定目标和确定动机、建立支持网络以及获得家人和朋友的支持。需要治疗的复杂性和适应新的健康状况被认为是自我管理的障碍。
参与者描述了协作咨询和护理连续性的重要性。定制的干预措施应确定参与自我管理的个性化目标和动机。关于有效管理症状和合并症的教育可以帮助减轻 KTR 感知的治疗负担。家庭和同伴支持可以在情感上支持 KTR；但是，管理移植的情绪负担需要更多关注。
