Self-management in adults after solid-organ transplantation: a scoping review protocol

Abstract

IntroductionAfter solid-organ transplantation (SOTx), recipients must adhere to a lifelong medical regimen, change their lifestyle and cope with physiological and psychosocial challenges. This requires active participation in their care and self-management abilities. The concept of self-management after SOTx has only been described regarding specific organs and focused on adherence to medical treatment. A comprehensive conceptualisation of self-management entailing all solid organs and beyond medical aspects does not exist. This might lead to unmet self-management support needs of SOTx recipients and hinder a more holistic and integrative approach in self-management support. Therefore, a better understanding of the concept of self-management after SOTx is needed to facilitate a comprehensive evidence base for healthcare providers and researchers. The purpose of this scoping review is to explore existing evidence on self-management in adults after SOTx.Methods and analysisTo identify relevant evidence, six electronic databases and three study registers will be searched, supplemented by handsearches, reference checking and expert recommendations. Screening and selection of available evidence will be carried out in a two-step process by two independent reviewers. International evidence published in English or German reporting on adults after heart, lung, liver, pancreas, kidney or small bowel transplantation will be considered. To meet inclusion criteria, articles have to focus on either: self-management, self-management support or recipients’ or healthcare providers’ perspectives of challenges and needs potentially addressable by self-management. Data extraction will be performed by two reviewers independently using a structured form. Data will be analysed descriptively and using content analysis procedures. Findings will be summarised narratively and presented in tabular format.Ethics and disseminationThe consultation and approval of an ethics committee is not required for this scoping review. Findings of the scoping review will be published in a peer-reviewed open-access journal and presented at conferences.

Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study

“…In brief, the initial set of definitions from the SMART study scoping review conducted from inception to September 2021 was obtained. A protocol detailing the SMART study search design has been published elsewhere [ 36 ]. The SMART study scoping review included 742 records (initially 34.045 records from database and supplementary searches).…”

“…This study applied a second screen to the definitions identified from the included 742 SMART study records containing a definition of SM for SOTx. The broader SMART study eligibility criteria focused on published articles on self-management of challenges and needs, published in English or German reporting on adults after SOTx, that is, heart, lung, liver, pancreas, kidney, or small bowel transplantation; it is reported in full elsewhere [ 36 ]. We aimed to identify definitions of self-management (including the term self-management support) but not associated concepts such as self-efficacy or self-care.…”

“…Other authors have also advocated for more clearly defined terms such as SM self-care [ 34 ] and social support [ 35 ]. Therefore, definitions of SM are a resource for nurses and other professionals (especially in the absence of professional guidance for SM [ 36 ]).…”

“…This study is a part of a larger research project called the SMART study [ 36 ], consisting of a synthesis of evidence on aspects of SM after SOTx in preparation for intervention development. This scoping review focused on international empirical literature on self-management, self-management support, or recipients’ or healthcare providers’ perspectives of challenges and needs potentially addressable by SM.…”

“…Study objectives were (1) to identify and critically review the existing definitions for SOTx SM in empirical research and (2) to propose a comprehensive definition of SM for SOTx informed by feedback from an expert panel—by asking the following research questions: how has the concept of SM been defined in the literature for the patient group SOTx [ 36 ]? What are the characteristics and conceptual underpinnings of these definitions, and are they considered adequate?…”