Development of a nurse-led self-management intervention for kidney transplant recipients using intervention mapping: the ZENN-study

Abstract

Background: Improving self-management is a potential way to optimize post-transplant outcomes. However, proven effective interventions aimed at promoting self-management after kidney transplantation are limited. The objective of this study was to describe the systematic development of a nurse-led self-management intervention for kidney transplant recipients. Methods: The Intervention Mapping approach was used in order to develop a pilot intervention which incorporates patients’ needs, theories and evidence based methods. The needs of kidney transplant recipients were assessed by reviewing the literature, conducting focus groups and a Q-methodological study (step 1). Based on the needs assessment change objectives were formulated (step 2). Evidence-based methods to achieve these objectives were selected and subsequently translated into practical implementation strategies (step 3). The intervention protocol was developed accordingly (step 4). Implementation is scheduled for November 2015 – June 2016 (step 5), and feasibility will be evaluated using a pre-post questionnaire and interviews with patients and medical staff (step 6). Findings: The intervention is designed to improve self-management utilizing evidence-based methods derived from health behaviour change theories, principles of solution focused brief therapy and motivational interviewing. Four sessions, each of which take 15 minutes, are added to the standard medical care provided by the nurse practitioners in the outpatient clinic. In this series of sessions patients will be encouraged to develop goal setting, action planning and pursuit skills and apply these to self-management issues they currently face. Conclusions: The intervention mapping approach provided a useful framework for integrating patients’ needs, evidence and theories in intervention development.