Factors Influencing Self-Management Behaviors Among Patients with Post-Kidney Transplantation: A Qualitative Study of the Chronic Phase Transition

Abstract

Background: Kidney transplantation is an effective treatment for patients with kidney failure. Despite the advances in technology, a certain number of patients still deteriorate due to improper management. The purpose of this study was to identify the promoting and inhibitory factors that influence recipients’ self-management behaviors after a kidney transplant. Methods: We enrolled participants who had kidney transplants for more than one year, aged ≥20 years from outpatient clinics in Japan. Face-to-face interviews were conducted between April and December 2016. Results: Nine participants were included in this study. By qualitative content analysis, 115 codes and 8 categories were extracted for the factors resulting in maintenance and the promotion of self-management behaviors; those were [attentiveness to changes in one’s own body], [good partnership with medical care providers], [past painful experiences], [establishment of lifestyle habits], [autonomy to protect one’s own body], [support from family and others], [gratitude for kidney donation], and [increased self-efficacy]. We also extracted three categories that inhibited self-management behavior: [fading threat of worsening disease], [shifting priorities], and [decreased motivation to control the disease]. Conclusions: The passage of time after transplant became a barrier to continue self-management. Providing knowledge about the importance of self-management can prevent the deterioration of kidney function over time after a transplant.