‘Back to Life’—Using knowledge exchange processes to enhance lifestyle interventions for liver transplant recipients: A qualitative study

Abstract

Aim 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. Methods 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. Results 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. Conclusions 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.

Investigating Whether the Mediterranean Dietary Pattern Is Integrated in Routine Dietetic Practice for Management of Chronic Conditions: A National Survey of Dietitians

“…Of note, SOT centres across Australia remain centralised within tertiary metropolitan hospitals in each state and specialist care within community services may be limited for transplant-related chronic disease management [51], which was raised in survey comments. Consumer engagement with liver transplant recipients demonstrated that patients have a desire to continue to engage with specialist clinicians from the transplant centres [52]. For SOT recipients, of which annual numbers have increased by 80% over the past decade [53], there is merit to consider training of dietitians more widely on long-term dietary management for reduction of cardiometabolic risk.…”

Diet and physical activity after liver transplant: A qualitative study of barriers and facilitators to following advice

“…Participants’ coping strategies influenced their behaviours. The desire to look after the transplanted liver has also been identified as a source of motivation for healthy behaviours in other studies 10,23 . However, we found that some participants did not feel able to consider the impact of their behaviours on their health because this threatened their ability to cope.…”

“…Our findings suggest that inadequate support with, and guidance about, the type and timing of activity that is safe after discharge from hospital is an important barrier to be addressed to enable self‐regulation. Similarly, other qualitative research has found uncertainty about how to progress activity as a result of participants’ inability to assess the safety of exercise after liver transplant 23 . van Adrichem et al 24 .…”

Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme: A qualitative study

“…We previously identified that employment is a high priority for individuals post-transplant, to regain a sense of normality after undergoing a life-shifting event. 16 It highlights the importance of co-designing treatment plans that meet the end-users' needs, including prioritisation of employment commitments within lifestyle prescriptions and innovating service delivery options within the tertiary hospital system.…”