INVESTIGATION OF PARAMETERS AFFECTING SELF-MANAGEMENT POWER IN KIDNEY TRANSPLANT RECIPIENTS
Yıl 2023,
, 112 - 117, 03.01.2023
Elif Dizen Kazan
,
Onur Tunca
Öz
OBJECTIVE: Kidney transplantation is one of the types of renal replacement therapy that can be performed in patients with end-stage renal disease. The power to perform activities that require the patient to maintain his life and health is called self-management power. Better health outcomes are inevitable in patients with high self-management power. In this study, we aimed to investigate the parameters affecting the self-management power in kidney transplant recipients.
MATERIAL AND METHODS: All kidney transplant recipients who were followed up from the nephrology outpatient clinic and applied to the nephrology outpatient clinic between July 2022 and September 2022 were interviewed. Self-management power was assessed using the self-care agency scale. Parameters correlated with self-management power were evaluated by linear regression analysis.
RESULTS: The study was conducted with 128 kidney transplant recipients. The mean age of the patients was 44.63±13.5 years. The mean self-management power score was 112.86±14.6. A correlation was found between self-management power and age, number of drugs used, time after transplantation, and number of chronic diseases. Age was found to be the strongest parameter affecting self-management power in the linear regression model.
CONCLUSIONS: Both graft and patient survival can be improved with a good knowledge of the factors that affect self-management in kidney transplant recipients. Some demographic and clinical factors may affect the power of self-management. Although the success in kidney transplantation is mostly attributed to the transplantation center, it should be kept in mind that the self-management power of the patient can also contribute to this success, and approaches that can improve the sef-management power should be applied.
Kaynakça
- 1. Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras. (1992). 2020;66:3-9.
- 2. Kang SH, Chung BH, Choi SR, et al. Comparison of clinical outcomes by different renal replacement therapy in patients with end-stage renal disease secondary to lupus nephritis. Korean J Intern Med.
2011;26(1):60-7.
- 3. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999 ;341(23):1725-
30.
- 4. Jansz TT, Bonenkamp AA, Boereboom FTJ, van Reekum FE, Verhaar MC, van Jaarsveld BC. Health-related quality of life compared between kidney transplantation and nocturnal hemodialysis. PLoS One.
2018;20;13(9):e0204405.
- 5. Tonelli M, Wiebe N, Knoll G, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11(10):2093-109.
- 6. Seyahi N, Ateş K, Süleymanlar G. Current Status of Renal Replacement Therapy in Turkey: A Summary of the 2019 Turkish Society and Nephrology Registry Report. Turkish Journal of Nephrology. 2021;30:105-11.
- 7. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7.
- 8. Aminuddin HB, Jiao N, Jiang Y, et al. Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with
type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud. 2021;116:103286.
- 9. Li R, Liang N, Bu F, Hesketh T. The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth. 2020;27;8(3):e17776.
- 10. Lean M, Fornells-Ambrojo M, Milton A, et al. Self-management interventions for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2019;214(5):260-8.
- 11. Jamieson NJ, Hanson CS, Josephson MA, et al. Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies. Am J Kidney Dis.
2016;67(3):461-78.
- 12. Kearney BY, Fleischer BJ. Development of an instrument to measure exercise of self-care agency. Res Nurs Health. 1979;2(1):25-34.
- 13. Nahcivan N. Sağlıklı gençlerde öz-bakım gücü ve aile ortamının etkisi. Doktora Tezi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı,1993.
- 14. Pınar R. Diyabetes Mellitus’lu hastaların yaşam kalitesi ve yaşam kalitesini etkileyen faktörlerin incelenmesi. Doktora Tezi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, 1995.
- 15. Bakoğlu E, Yetkin A. Hipertansiyonlu hastaların öz-bakım gücünün değerlendirilmesi. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2000;4:41-9.
- 16. Mollaoğlu M. Hemodiyaliz uygulanan hastalarda öz-bakım gücü ve depresyon. Nefroloji Hemşireliği Dergisi. 2005;2:55-60.
- 17. Bakoğlu E, Şekerci K, Yaman S, Çevik M. Periton Diyalizli hastalarda Öz-Bakım Gücü. Fırat Sağlık Hizmetleri Dergisi. 2009;4:65-78.
- 18. Akyolcu N. Patient education in renal transplantation. EDTNA ERCA J. 2002;28(4):176-9.
- 19. Murphy F. The role of the nurse post-renal transplantation. Br J Nurs. 2007;16(11):667-75.
- 20. Kobus G, Małyszko J, Małyszko JS, Puza E, Bachórzewska-Gajewska H, Myśliwiec M. Compliance with lifestyle recommendations in kidney allograft recipients. Transplant Proc. 2011;43(8):2930-4.
- 21. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;23;351(13):1296-305.
- 22. Gill JS. Potential advantages and limitations of applying the chronic kidney disease classification to kidney transplant recipients. Am J Transplant. 2006;6(12):2821-6.
- 23. Cramm JM, Twisk J, Nieboer AP. Self-management abilities and frailty are important for healthy aging among community-dwelling older people; a cross-sectional study. BMC Geriatr. 2014;14:28.
- 24. Li PS, Hsieh CJ, Miao NF. A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan. J Nurs Res. 2020;28(6):e124.
- 25. Davis JC, Bryan S, Li LC, et al. Mobility and cognition are associated with wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver Falls Prevention Cohort. BMC
Geriatr. 2015;5;15:75.
- 26. Demirbas N, Kutlu R. Çoklu ilaç kullanan yetişkin bireylerin tedaviye uyumu ve öz-etkililik düzeyleri. Ankara Medical Journal. 2020(2):269-80.
- 27. Vankova B, Mala-Ladova K, Kubena AA, Maly J, Sulkova SD. Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients. Patient Prefer Adherence.
2018;12:2605-13.
- 28. Liddy C, Blazkho V, Mill K. Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature. Can Fam Physician. 2014;60(12):1123-33.
- 29. Bayliss EA, Ellis JL, Steiner JF. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Ann Fam Med. 2007;5(5):395-402.
- 30. Gobeil-Lavoie AP, Chouinard MC, Danish A, Hudon C. Characteristics of self-management among patients with complex health needs: a thematic analysis review. BMJ Open. 2019;24;9(5):e02834
BÖBREK NAKLİ ALICILARINDA ÖZ-YÖNETİM GÜCÜNÜ ETKİLEYEN PARAMETRELERİN ARAŞTIRILMASI
Yıl 2023,
, 112 - 117, 03.01.2023
Elif Dizen Kazan
,
Onur Tunca
Öz
AMAÇ: Böbrek nakli son dönem böbrek yetmezliği olan hastalarda yapılabilen renal replasman tedavisi türlerinden birisidir. Hastanın yaşamını ve sağlığını idame ettirmeyi gerektiren aktiviteleri yapabilme gücüne öz-yönetim gücü denir. Öz-yönetim gücü yüksek olan hastalarda daha iyi sağlık sonuçları olması kaçınılmazdır. Bu çalışmamızda böbrek nakli alıcılarında öz-yönetim gücünü etkileyen parametreleri araştırmayı amaçladık.
GEREÇ VE YÖNTEM: Nefroloji polikliniğinden takipli ve Temmuz 2022 - Eylül 2022 tarihleri arasında nefroloji polikliniğine başvuran tüm böbrek nakli alıcıları ile görüşüldü. Öz-yönetim gücü öz-bakım ajansı ölçeği kullanılarak değerlendirildi. Öz-yönetim gücü ile korele bulunan parametreler lineer regresyon analizi ile değerlendirildi.
BULGULAR: Çalışma 128 böbrek nakli alıcısı ile yapıldı. Hastaların ortalama yaşı 44.63±13.5 yıldı. Ortalama öz-yönetim gücü skoru 112.86±14.6 idi. Öz-yönetim gücü ile yaş, kullanılan ilaç sayısı, nakilden sonra geçen süre ve kronik hastalık sayısı arasında bir korelasyon saptandı. Lineer regresyon modelinde öz-yönetim gücünü etkileyen en güçlü parametre yaş olarak bulundu.
SONUÇ: Böbrek nakli alıcılarında öz-yönetim gücünü etkileyen faktörlerin iyi bilinmesi ile hem greft hem de hasta sağkalımı iyileştirilebilir. Demografik ve klinik bazı faktörler öz-yönetim gücünü etkileyebilir. Böbrek naklinde başarı daha çok nakil merkezine atfedilse de hastanın öz-yönetim gücünün de bu başarıya katkı sağlayabileceği akılda tutulmalı ve öz-yönetim gücünü geliştirebilecek yaklaşımlar sergilenmelidir.
Kaynakça
- 1. Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras. (1992). 2020;66:3-9.
- 2. Kang SH, Chung BH, Choi SR, et al. Comparison of clinical outcomes by different renal replacement therapy in patients with end-stage renal disease secondary to lupus nephritis. Korean J Intern Med.
2011;26(1):60-7.
- 3. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999 ;341(23):1725-
30.
- 4. Jansz TT, Bonenkamp AA, Boereboom FTJ, van Reekum FE, Verhaar MC, van Jaarsveld BC. Health-related quality of life compared between kidney transplantation and nocturnal hemodialysis. PLoS One.
2018;20;13(9):e0204405.
- 5. Tonelli M, Wiebe N, Knoll G, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11(10):2093-109.
- 6. Seyahi N, Ateş K, Süleymanlar G. Current Status of Renal Replacement Therapy in Turkey: A Summary of the 2019 Turkish Society and Nephrology Registry Report. Turkish Journal of Nephrology. 2021;30:105-11.
- 7. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7.
- 8. Aminuddin HB, Jiao N, Jiang Y, et al. Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with
type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud. 2021;116:103286.
- 9. Li R, Liang N, Bu F, Hesketh T. The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth. 2020;27;8(3):e17776.
- 10. Lean M, Fornells-Ambrojo M, Milton A, et al. Self-management interventions for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2019;214(5):260-8.
- 11. Jamieson NJ, Hanson CS, Josephson MA, et al. Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies. Am J Kidney Dis.
2016;67(3):461-78.
- 12. Kearney BY, Fleischer BJ. Development of an instrument to measure exercise of self-care agency. Res Nurs Health. 1979;2(1):25-34.
- 13. Nahcivan N. Sağlıklı gençlerde öz-bakım gücü ve aile ortamının etkisi. Doktora Tezi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı,1993.
- 14. Pınar R. Diyabetes Mellitus’lu hastaların yaşam kalitesi ve yaşam kalitesini etkileyen faktörlerin incelenmesi. Doktora Tezi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, 1995.
- 15. Bakoğlu E, Yetkin A. Hipertansiyonlu hastaların öz-bakım gücünün değerlendirilmesi. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2000;4:41-9.
- 16. Mollaoğlu M. Hemodiyaliz uygulanan hastalarda öz-bakım gücü ve depresyon. Nefroloji Hemşireliği Dergisi. 2005;2:55-60.
- 17. Bakoğlu E, Şekerci K, Yaman S, Çevik M. Periton Diyalizli hastalarda Öz-Bakım Gücü. Fırat Sağlık Hizmetleri Dergisi. 2009;4:65-78.
- 18. Akyolcu N. Patient education in renal transplantation. EDTNA ERCA J. 2002;28(4):176-9.
- 19. Murphy F. The role of the nurse post-renal transplantation. Br J Nurs. 2007;16(11):667-75.
- 20. Kobus G, Małyszko J, Małyszko JS, Puza E, Bachórzewska-Gajewska H, Myśliwiec M. Compliance with lifestyle recommendations in kidney allograft recipients. Transplant Proc. 2011;43(8):2930-4.
- 21. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;23;351(13):1296-305.
- 22. Gill JS. Potential advantages and limitations of applying the chronic kidney disease classification to kidney transplant recipients. Am J Transplant. 2006;6(12):2821-6.
- 23. Cramm JM, Twisk J, Nieboer AP. Self-management abilities and frailty are important for healthy aging among community-dwelling older people; a cross-sectional study. BMC Geriatr. 2014;14:28.
- 24. Li PS, Hsieh CJ, Miao NF. A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan. J Nurs Res. 2020;28(6):e124.
- 25. Davis JC, Bryan S, Li LC, et al. Mobility and cognition are associated with wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver Falls Prevention Cohort. BMC
Geriatr. 2015;5;15:75.
- 26. Demirbas N, Kutlu R. Çoklu ilaç kullanan yetişkin bireylerin tedaviye uyumu ve öz-etkililik düzeyleri. Ankara Medical Journal. 2020(2):269-80.
- 27. Vankova B, Mala-Ladova K, Kubena AA, Maly J, Sulkova SD. Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients. Patient Prefer Adherence.
2018;12:2605-13.
- 28. Liddy C, Blazkho V, Mill K. Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature. Can Fam Physician. 2014;60(12):1123-33.
- 29. Bayliss EA, Ellis JL, Steiner JF. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Ann Fam Med. 2007;5(5):395-402.
- 30. Gobeil-Lavoie AP, Chouinard MC, Danish A, Hudon C. Characteristics of self-management among patients with complex health needs: a thematic analysis review. BMJ Open. 2019;24;9(5):e02834