Development of Self-Management Scale for Kidney Transplant Recipients, Including Management of Post-Transplantation Chronic Kidney Disease

Abstract

An evaluation scale is indispensable for the promotion of continuing, effective postkidney transplantation self-management behaviors. We aimed to develop and validate a new self-management scale for kidney transplant recipients to improve their long-term outcomes and prevent the recurrence of CKD complications. Two hundred and thirty-nine Japanese patients who had undergone kidney transplantation were recruited from three hospitals. The scale's validity and reliability were evaluated using exploratory factor analysis and intraclass correlation coefficients. Scale items were selected by considering the findings of a clinical importance survey of 17 experts. Four subscales were identified by the factor analysis: "Self-monitoring" (six items), "Self-care behavior in daily living" (seven items), "Early detecting and coping with abnormalities after kidney transplantation" (four items), and "Stress management" (three items). Cronbach's alpha coefficients for the subscales ranged from 0.61 to 0.87. A further four items with high clinical importance were added to the scale. The final scale comprised 24 items within four subscales and four single items. The intraclass correlation ranged from 0.88 to 0.95 in each subscale and the weighted kappa coefficient for the single items ranged from 0.33 to 0.72. The validity and reliability of our new self-management scale were confirmed by a patient-based field survey.

A Gap Analysis Assessing the Perceptions of Primary Care Physicians in the Management of Kidney Recipients After Transplantation

“…A survey-based study showed that the degree of adherence to transplantation regimens is negatively correlated with time since transplantation. 19 Improving patient self-management may increase adherence to transplantation regimens, thus improving long-term transplant outcomes and reducing the occurrence of complications. 20,21 It has been suggested that patient education alone is not sufficient to improve clinical outcomes but should also be combined with behavioral change.…”

Attainment of the Elusive

“…46 In a study of kidney transplant patients, the degree of adherence to self-management regimens is negatively correlated with time after transplantation. 47 Thus, participation in decision-making or possessing a high level of self-management skills can positively affect kidney transplant longevity.…”

Study protocol: The effect of motivational interviewing on self-management in adult kidney transplant recipients (MIAKTR)

“…The self-management scale is the first scale to be applied as a preliminary test in kidney transplant recipients. [ 21 ] Turkish version of the 4-point Likert scale includes 13 items. Scale items are scored as 1”never applied”, 2 “applied slightly”, 3 “applied very often” and 4 “fully applied”.…”