Shedding light on an unknown reality in solid organ transplant patients' self‐management: A contextual inquiry study. Issue 8 (2nd July 2018)

• Record Type: Journal Article
• Authors: Vanhoof, Jasper M. M.; Vandenberghe, Bert; Geerts, David; Philippaerts, Pieter; De Mazière, Patrick; DeVito Dabbs, Annette; De Geest, Sabina; Dobbels, Fabienne
• Other Names: Dupont Lieven investigator.; Kuypers Dirk investigator.; Monbaliu Diethard investigator.; Nevens Frederik investigator.; Pirenne Jacques investigator.; Troosters Thierry investigator.; Van Cleemput Johan investigator.; Vanhaecke Johan investigator.; Van Raemdonck Dirk investigator.; Verleden Geert investigator.; Vos Robin investigator.
• Is Part Of: Clinical transplantation. Volume 32:Issue 8(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-07-02
• Subjects: adherence -- contextual inquiry -- lifestyle -- medication -- needs -- self‐management -- transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.13314
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Traditional quantitative and qualitative research methods inadequately capture the complexity of patients' daily self‐management. Contextual inquiry methodology, using home visits, allows a more in‐depth understanding of how patients integrate immunosuppressive medication intake, physical activity, and healthy eating in their daily lives, and which difficulties they experience when doing so. This mixed‐method study comprised 2 home visits in 19 purposively selected adult heart, lung, liver, and kidney transplant patients, asking them to demonstrate how they implement the aforementioned health behaviors. Meanwhile, conversations were audio‐taped and photographs were taken. Audio‐visual materials were coded using directed content analysis. Difficulties and supportive strategies were identified via inductive thematic analysis. We learned that few patients understood what "sufficiently active" means. Physical discomforts and poor motivation created variation across activity levels observed. Health benefits of dietary guidelines were insufficiently understood, and their implementation into everyday life considered difficult. Many underestimated the strictness of immunosuppressive medication intake, and instructions on handling late doses were unclear. Interruptions in routine and busyness contributed to nonadherence. We also learned that professionals often recommend supportive strategies, which patients not always like or need. This contextual inquiry study revealed unique insights, providing a basis for patient‐tailored self‐management interventions.