Background: Self-management is the key point to maintain the graft kidney function and the survival of renal transplant recipients. However, the level of self-management is not adequate and the factors influencing self-management in renal transplant recipients were not studied sufficiently.
Objective: This study was to explore the influencing factors of the self-management in renal transplant recipients based on the Health Promotion Model.
Methods：Data was collected from 270 kidney transplant recipients who were regularly followed up at the outpatient clinics of three tertiary hospitals 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.
Results：The self-management scores of renal 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), and the score indexes were 86.54%, 87.50% and 87.50% respectively. The results of structural equation model showed that the final model had significant consistency with the data. Economic burden, work status, habitual residence, education level, depression, anxiety, self-efficacy and self-management support accounted for 42% of the variance on self-management. The order of the total effect of each factor on self-management from high to low is: self-management support (β=0.566), anxiety (β=-0.243), education level (β=0.166), self-efficacy (β=0.165), habitual residence (β=-0.112), economic burden (β=-0.019), depression (β=-0.017), and work status (β=-0.013).
Conclusion：We can explain the influencing factors of self-management in renal transplant recipients using the Health Promotion Model. The overall level of self-management in renal transplantation recipients is high, but there are still differences among different groups of characteristics. The self-management in renal transplant recipients was mainly affected by self-management support and anxiety. The transplant professionals should pay attention to these influencing factors when making interventions to improve the level of self management in renal transplant recipients. Keywords: health promotion model; kidney transplantation; self-management; self-management support