Exploring health literacy and self-management after kidney transplantation: a prospective cohort study

L. Maasdam, R. Timman, M. Cadogan, M. Tielen, M.C. de Haan, W. Weimar, E.K.J. Massey

Wednesday 4 march 2020

14:40 - 14:50h at Leo Franssen zaal

Parallel session: Parallel sessie V – Donatie en Verpleegkundige abstracts

Background: Health literacy and self-management skills may influence how patients interpret and act on information about post-transplant self-care. This study aimed to investigate the influence of health literacy and self-management on complications, kidney function and graft failure after kidney transplantation.

Methods: We performed a prospective cohort study and included patients who received a kidney transplant between May 2012 –May 2013, and monitored them until December 2018. We measured health literacy and self-management before discharge and 6 and 12 months after transplantation. Health literacy was measured using the Newest Vital Sign and self-management using the Partner in Health scale. Subscales are aftercare & knowledge, coping, recognition and management of symptoms, healthy lifestyle. Complications were rejection, viral infections, and bacterial infections. Kidney function was measured by eGFR and graft survival with days until failure.

Results: We included 154 patients (73% response rate). Higher health literacy at baseline and at 12 months was related to more viral infections (p=0.02; p <0.01). No relationships were found between health literacy and kidney function and graft failure. Lower ‘coping’ at baseline was related to more bacterial infections (p=0.02). Higher ‘after-care and knowledge’ at 6 months (p<0.01), and ‘recognition and management of symptoms’ at 6 months were associated with lower graft failure (p<0.01).

Conclusions: Higher knowledge and management of symptoms were related to lower graft failure. Promoting these components of self-management may improve outcomes after kidney transplantation. There were few relationships found between health literacy and kidney transplant outcomes, which is contrary to previous studies. The support of self-management post-transplant is important, and is thus a key focus for nurses in the multidisciplinary team.