A Mixed-Method Study to Explore Patients' Perspective of Self-Management Tasks in the Early Phase after Kidney Transplant

Abstract

Context Patients' perspectives of posttransplant self-management tasks have not been explored. Objective To explore the concept and the presence of self-management tasks mastered by patients in the early phase after kidney transplant. Design Mixed-method study using semistructured interviews and a structured questionnaire. Setting Outpatient Division of Nephrology at University Hospital Zurich, Switzerland Patients Twelve patients (median age, 52 years, interquartile range, 42.25–65.25 years; median time after kidney transplant, 6.5 months; interquartile range, 2.25–15.75 months) were included. Analysis Qualitative data were analyzed according to Corbin and Strauss' 3 self-management tasks with content analysis procedures. In the quantitative analysis, the presence of each self-management task is expressed as a frequency. Results The qualitative findings showed that patients were greatly challenged by the effort to manage the upcoming instability, which has a persistent broad impact on their lives. Managing emotions comprised dealing with uncertainty, disappointment, and frustration. Additionally, patients had to manage changes in self-perception. Managing life roles mainly involved an adaptation of relationships, occupational changes, and interactions with health care providers. Taking medications, managing symptoms, integrating new behaviors, and understanding one's course of disease were further tasks. Quantitatively, self-management tasks that were perceived as a challenge by at least half of the patients were primarily tasks from the questionnaire section “managing stressful emotions and self-perception.” The synthesis of qualitative and quantitative findings indicates that self-management programs for kidney transplant recipients should focus on strengthening patients' self-management of emotional tasks and on regaining stability in daily life.