Valuating the effects of a nurse-led self-management intervention for kidney transplant patients: mixed-method design

J.M.J. Been-Dahmen, D. Beck, M.A.C. Peeters, H. van der Stege, J. Grijpma, M. Tielen, M. van Buren, W. Weimar, E. Ista, A. van Staa, E.K. Massey

Thursday 15 march 2018

16:45 - 16:55h at Van de Vorm/Plate Zaal

Categories: Nursing, Session (parallel)

Parallel session: Parallel session 9: Nursing

Aim

In order to support patients to take an active role in their post-transplant care in the form of self-management, a holistic nurse-led intervention was developed with the Intervention Mapping Protocol1. This intervention consists of four 15-minute sessions with a nurse practitioner. During the sessions the nurse encourages patients to assess self-management challenges with a conversational tool called the Self-Management Web. Once the challenges have been identified, using a solution-focused communication style, patients are encouraged to set goals, make action plans, monitor progress and apply problem-solving skills to other challenges. This study aimed to evaluate the feasibility of this intervention for kidney transplant patients and professionals.

Method

A mixed-method pilot study was conducted in 2016-2017. To select patients who visited the outpatient post-transplantation clinic of a Dutch University Hospital, a total sampling approach was used. Qualitative methods (observations and interviews) were used to get insight in the fidelity, feasibility, and acceptability. Quantitative methods (pre-post surveys within-group comparison; and intervention versus a historic control between-group comparison) were used to examine the fidelity and to evaluate effects on self-efficacy and quality of life.

Results

Thirty-one patients were invited to participate in the intervention group. Twenty-three completed the intervention and 16 filled in the pre- and post surveys. The control group consisted of 43 patients. Most patients characterized the holistic focus of this intervention as a welcome addition to traditional care. It helped them to build a relationship of trust with their nurse, which was conditional for discussing self-management challenges. Patients also described that they became more competent in problem-solving skills. The quantitative analysis indicated a significant increase in quality of life after receiving the intervention. Also, after implementation of the intervention quality of care improved significant.

Conclusion

This holistic self-management support intervention seems a promising tool to help kidney transplant patients deal with daily life challenges. More research is needed with a larger sample to increase insight into the working mechanisms and effects of using this Self-Management support intervention in chronic patients