| Objective:1.To describe the status of self-management in kidney transplant recipients;2.Based on the health promotion model,to explore the influencing factors of the self-management of kidney transplant recipients at the level of personal traits and experience,specific behavioral cognitive and emotional levels,so as to provide a reference for the proposal of self-management clinical intervention for kidney transplant recipients.Methods:In this study,data was collected from 270 kidney transplant recipients who were regularly followed up in outpatient clinics of three tertiary hospitals in Beijing and Changsha from October 2020 to February 2021 by convenience sampling method.The survey tools used included General Information Questionnaire,Kidney Transplant Recipient Self-management Support Scale,Self-efficacy for Managing Chronic Disease 6-Item Scale,Kidney Transplant Recipient Self-management Scale,and Hospital Anxiety and Depression Scales.SAS 9.40 and Amos 24.0 were used for statistical analysis of the data,in which SAS 9.40 was used for descriptive analysis,univariate analysis and Spearman correlation analysis,and Amos 24.0 was used to construct structural equation model for the data.Results:1.270 questionnaires were distributed and 270 were recovered with a recovery rate of 100%.Among them,265 were effective questionnaires,and the effective rate of questionnaire recovery was 98.15%.2.The self-management scores of kidney transplant recipients were:Problem solving was 35.00(30.00,40.00),Partnership was 14.00(12.00,16.00),Self-care was 45.00(40.00,49.00),the score indexes were 86.54%,87.50%and 87.50%respectively.The Self-management support scores:Tool support was 43.00(36.00,45.00),Psychosocial support was 40.00(34.00,45.00),Relationship support was 20.00(16.00,20.00).The Self-efficacy scores:Symptom management self-efficacy was 8.50(6.50,9.50),Comorbidity management self-efficacy was 8.00(6.50,10.00).3.Univariate analysis showed that there are statistically significant differences in the self-management in kidney transplant recipients with different age,BMI,residence,working status,educational level,economic burden,and post-transplantation time,indicating that the recipients with different characteristics show different self-management management level.4.The results of structural equation model showed that economic burden,work status,residence,education level,depression,anxiety,self-efficacy and self-management support accounted for 42%of the variance variation in self-management,which indicated that this model could explain the influencing factors of self-management of kidney transplant recipients better.The order of the effect of each factor on self-management from high to low is:self-management support,anxiety,education level,self-efficacy,residence,economic burden,depression,work status.Conclusion:1.The overall level of self-management of kidney transplantation recipients is high,but there are still differences among different recipients of characteristics.Among them,the self-management level of kidney transplantation recipients is different among different ages,BMI,residence,work status,educational level,economic burden and post-transplantation time.2.The self-management of kidney transplant recipients was affected by self-management support,self-efficacy and psychological state.The self-management level of kidney transplant recipients with high self-management support,high self-efficacy and no anxiety and depression was high.3.The model built on the basis of the Health Promotion Model can explain the influencing factors of the self-management of kidney transplant recipients.Self-efficacy and self-management support are intermediary variables in this model.Formulating self-management intervention measures,clinical staffs should pay attention to improving the self-efficacy and self-management support of kidney transplant recipients,in order to improve the self-management level of kidney transplant recipients... |
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