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Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study

BACKGROUND: To support effective self-management after kidney transplantation, a holistic nurse-led self-management support intervention was developed using the Intervention Mapping approach. The primary aim was to evaluate the feasibility, acceptability and fidelity of the intervention for kidney t...

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Autores principales: Been-Dahmen, Janet M. J., Beck, Denise K., Peeters, Mariëlle A. C., van der Stege, Heleen, Tielen, Mirjam, van Buren, Marleen C., Ista, Erwin, van Staa, AnneLoes, Massey, Emma K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486974/
https://www.ncbi.nlm.nih.gov/pubmed/31029107
http://dx.doi.org/10.1186/s12882-019-1300-7
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author Been-Dahmen, Janet M. J.
Beck, Denise K.
Peeters, Mariëlle A. C.
van der Stege, Heleen
Tielen, Mirjam
van Buren, Marleen C.
Ista, Erwin
van Staa, AnneLoes
Massey, Emma K.
author_facet Been-Dahmen, Janet M. J.
Beck, Denise K.
Peeters, Mariëlle A. C.
van der Stege, Heleen
Tielen, Mirjam
van Buren, Marleen C.
Ista, Erwin
van Staa, AnneLoes
Massey, Emma K.
author_sort Been-Dahmen, Janet M. J.
collection PubMed
description BACKGROUND: To support effective self-management after kidney transplantation, a holistic nurse-led self-management support intervention was developed using the Intervention Mapping approach. The primary aim was to evaluate the feasibility, acceptability and fidelity of the intervention for kidney transplant recipients and professionals. The secondary aim was to explore preliminary effects on outcomes. METHODS: A pilot study was conducted in 2015–2017 to evaluate the intervention. Nurse Practitioners (NP) guided recipients in assessing 14 life areas using the Self-Management Web. Participants were supported in developing self-regulation skills which can be applied to self-management of the illness. Strategies included goal setting, action planning, and promotion of motivation and self-efficacy. Adult recipients from an outpatient clinic of a Dutch University Hospital who underwent their transplant at least 1 month ago, were invited to participate. NPs, nephrologists and recipients were interviewed to assess feasibility, fidelity and implementation experience. Consultations were videoed and analysed to assess fidelity. To assess the preliminary effects, the intervention group completed baseline (T0) and follow-up (T1) questionnaires on self-management behavior, self-efficacy, quality of life and quality of care. A historical control group of kidney transplant recipients completed the same questionnaires at T1. RESULTS: Twenty-seven recipients agreed to participate in the intervention group, of which 24 completed the intervention and 16 completed baseline and follow-up surveys. The control group consisted of 33 recipients. Professionals and recipients appraised the open, holistic focus of the intervention as a welcome addition to standard care and felt that this helped to build a relationship of trust. Recipients also felt they became more competent in problem-solving skills. The within-group analysis showed no significant increase in patients’ self-management skills. The between-groups analysis showed significantly higher medication adherence among the intervention group (P = 0.03; G = 0.81). The within-groups analysis showed a significantly higher perceived quality of care (P = 0.02) in the intervention group. CONCLUSION: This holistic nurse-led self-management support intervention was found to be feasible and acceptable by professionals and recipients alike. This pilot had a small sample therefore further research is needed into the potential effects on self-management behavior and well-being of transplant recipients. ISRCTN Trial Registry: ISRCTN15057632 (registered retrospectively on 20-07-2018). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-019-1300-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-64869742019-05-06 Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study Been-Dahmen, Janet M. J. Beck, Denise K. Peeters, Mariëlle A. C. van der Stege, Heleen Tielen, Mirjam van Buren, Marleen C. Ista, Erwin van Staa, AnneLoes Massey, Emma K. BMC Nephrol Research Article BACKGROUND: To support effective self-management after kidney transplantation, a holistic nurse-led self-management support intervention was developed using the Intervention Mapping approach. The primary aim was to evaluate the feasibility, acceptability and fidelity of the intervention for kidney transplant recipients and professionals. The secondary aim was to explore preliminary effects on outcomes. METHODS: A pilot study was conducted in 2015–2017 to evaluate the intervention. Nurse Practitioners (NP) guided recipients in assessing 14 life areas using the Self-Management Web. Participants were supported in developing self-regulation skills which can be applied to self-management of the illness. Strategies included goal setting, action planning, and promotion of motivation and self-efficacy. Adult recipients from an outpatient clinic of a Dutch University Hospital who underwent their transplant at least 1 month ago, were invited to participate. NPs, nephrologists and recipients were interviewed to assess feasibility, fidelity and implementation experience. Consultations were videoed and analysed to assess fidelity. To assess the preliminary effects, the intervention group completed baseline (T0) and follow-up (T1) questionnaires on self-management behavior, self-efficacy, quality of life and quality of care. A historical control group of kidney transplant recipients completed the same questionnaires at T1. RESULTS: Twenty-seven recipients agreed to participate in the intervention group, of which 24 completed the intervention and 16 completed baseline and follow-up surveys. The control group consisted of 33 recipients. Professionals and recipients appraised the open, holistic focus of the intervention as a welcome addition to standard care and felt that this helped to build a relationship of trust. Recipients also felt they became more competent in problem-solving skills. The within-group analysis showed no significant increase in patients’ self-management skills. The between-groups analysis showed significantly higher medication adherence among the intervention group (P = 0.03; G = 0.81). The within-groups analysis showed a significantly higher perceived quality of care (P = 0.02) in the intervention group. CONCLUSION: This holistic nurse-led self-management support intervention was found to be feasible and acceptable by professionals and recipients alike. This pilot had a small sample therefore further research is needed into the potential effects on self-management behavior and well-being of transplant recipients. ISRCTN Trial Registry: ISRCTN15057632 (registered retrospectively on 20-07-2018). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-019-1300-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-04-27 /pmc/articles/PMC6486974/ /pubmed/31029107 http://dx.doi.org/10.1186/s12882-019-1300-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Been-Dahmen, Janet M. J.
Beck, Denise K.
Peeters, Mariëlle A. C.
van der Stege, Heleen
Tielen, Mirjam
van Buren, Marleen C.
Ista, Erwin
van Staa, AnneLoes
Massey, Emma K.
Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title_full Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title_fullStr Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title_full_unstemmed Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title_short Evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
title_sort evaluating the feasibility of a nurse-led self-management support intervention for kidney transplant recipients: a pilot study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486974/
https://www.ncbi.nlm.nih.gov/pubmed/31029107
http://dx.doi.org/10.1186/s12882-019-1300-7
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