The Self Management Challenges and Support Needs Among Post Kidney Transplant Patients in the Renal Unit - Kenyatta National Hospital

Abstract

Background: Kidney transplantation has become the preferred renal replacement therapy (RRT) for patients with end stage renal disease both for improved quality of life and cost effectiveness. There has been a remarkable improvement in short-term survival rates of kidney transplant recipients. However, this has not been translated to long-term benefits, thus improving long-term survival rates remains a challenge both internationally and locally. Investing in post kidney transplant self-care strategies with a focus on improving various factors such as nutrition, therapy, exercising and psychosocial support is a promising pathway to improving long-term post-transplantation outcomes. Broad objective: To establish the self-management challenges and support needs among post kidney transplant patients at Kenyatta National Hospital. Study design and site: This study was a descriptive cross-sectional study whereby both quantitative and qualitative data were obtained. The study was conducted in the Renal Unit of Kenyatta National Hospital. A total of 140 post kidney transplant patients were sought, though 135 questionnaires were completely filled and included in the analysis. The collected data was entered into Epidata and then exported into SPSS version 26 for analysis. Quantitative data was analyzed both descriptively and inferentially where Fischer‘s test for association was used to investigate the association between patient characteristics and self-management practices. Qualitative data was analyzed using content analysis. Results: The findings showed that, 54.8% (n=74) of the respondents were male, 55.6% (n=75) of the respondents had secondary level education, 54.8%(n=74) of the respondents had average monthly income of ≤Ksh. 20,000. The finding from the study established that 93% of the patients viewed nutrition in care as essential in improving their health outcomes, However, 11.1% of the patients were having challenges in following the prescribed dietary regimen. The support needs included regular dietary counselling and financial support. The findings revealed that majority of the respondents, 89.6% take medication as prescribed while only 10.5% reported missing some doses in the last one month. The common challenges leading to missed doses included high cost of medications, forgetfulness, lack of support from caregivers and development of adverse side effects. The support needs identified included identifying other sources of financing in purchasing treatment drugs and ensure drug affordability. Majority of the respondents, 65.2% of the respondents did not have any negative effect of physical, emotional problems on their normal activities, 68.1% of the respondents perceived their physical activity level or capacity as being fairly adequate. Education level, marital status and average monthly income were significantly associated with physical body capacity perception among post kidney transplant patients. Persistent worries and fears about the illness and its long-term effects and fear of graft loss some of the time. The findings revealed that education level and marital status were significant factors influencing psychosocial wellbeing of post kidney transplant patients...................................................................................................................................................................................