JMIR Publications

ABSTRACT

Background:

Optimal self-management in kidney transplant recipients is essential for patient and graft survival, reducing comorbidity and healthcare costs while improving quality of life However, there are few effective interventions aimed at providing self-management support after kidney transplantation.

Objective:

The objective of this study was to systematically development a nurse-led, self-management (support) intervention for kidney transplant recipients.

Methods:

The Intervention Mapping protocol was used to develop an intervention which incorporates recipients’ and nurses’ needs, theories, and evidence-based methods. The needs of recipients and nurses were assessed by reviewing the literature, conducting focus groups, individual interviews, and observations (step 1). Based on the needs assessment, self-regulation theory and the ‘5As’ model, change objectives were formulated (step 2). Evidence-based methods to achieve these objectives were selected and subsequently translated into practical implementation strategies (step 3). Program materials and protocols were developed accordingly (step 4). Implementation was scheduled for 2015 –2017 (step 5). The last step of Intervention Mapping, evaluation of the intervention falls outside the scope of this paper (step 6).

Results:

The intervention was developed to optimize self-management (support) after kidney transplantation and targeted both the kidney transplant recipients as well as the nurse practitioners who provided the intervention. The intervention was clustered into four 15 minute sessions based on an intervention protocol that were added to the standard medical care in the outpatient clinic. Nurses received a training syllabus and were trained in communication techniques based on the principles of Solution-Focused Brief Therapy. Patients were encouraged to assess self-management challenges using the Self-Management Web and subsequently develop specific goals, action plans and pursuit skills to solve these challenges.

Conclusions:

The Intervention Mapping protocol provided an advantageous framework to systematically develop a self-management intervention in which nurses and patients’ needs, evidence-based methods and theories were integrated.