Erasmus MC Transplant Institute, Department of Internal Medicine, University Medical Center Rotterdam, Rotterdam, Netherlands.
Transpl Int. 2024 Jul 22;37:13192. doi: 10.3389/ti.2024.13192. eCollection 2024.
After transplantation self-management is essential for graft survival and optimal quality of life. To address the need for home-based support in self-management, we implemented the "SelfCare after Renal Transplantation" (SeCReT) box, containing home-monitoring equipment combined with a smartphone application that was linked to the electronic patient records. This study investigated the uptake and continuation, protocol adherence, and subjective evaluation of this home-monitoring program. All "" kidney recipients who received the SeCReT-box in the study period (Aug 2021-Dec 2022) were eligible for inclusion. Protocol adherence was defined as ≥75%. Subjective evaluation was assessed with a 5-item questionnaire. Of the 297 recipients transplanted, 178 participants (60%) were included in the analysis. Protocol adherence was 83%, 73%, 66%, and 57% respectively at 5, 10, 20, and 40 weeks of the protocol. With regard to continuation, 135 participants were still in the program at the end of the study period (75% retention rate). Regarding subjective evaluations, 82% evaluated the program positively, and 52% reported lower care needs due to home-monitoring. Results are positive among those who entered and continued the program. Qualitative research is needed on barriers to entering the program and facilitators of use in order to promote optimal implementation.
移植后自我管理对于移植物的存活和最佳生活质量至关重要。为了满足自我管理中对家庭支持的需求，我们实施了“肾移植后的自我护理”（SeCReT）盒子，其中包含家庭监测设备和与电子患者记录相关联的智能手机应用程序。本研究调查了该家庭监测计划的采用率、延续率、方案依从性和主观评价。在研究期间（2021 年 8 月至 2022 年 12 月）接受 SeCReT 盒子的所有“肾移植”受者都有资格入选。方案依从性定义为≥75%。主观评价采用 5 项问卷进行评估。在 297 名接受移植的受者中，有 178 名参与者（60%）纳入分析。方案依从性分别为 5、10、20 和 40 周时的 83%、73%、66%和 57%。关于延续性，在研究结束时，有 135 名参与者仍在该计划中（保留率为 75%）。关于主观评价，82%的参与者对该计划评价积极，52%的参与者报告由于家庭监测，护理需求降低。对于那些进入并继续该计划的人来说，结果是积极的。需要进行定性研究，以了解进入该计划的障碍和使用的促进因素，从而促进最佳实施。
