Abstract:
Background: Chronic disease of kidney is an important cause of global mortality &
morbidity. It has become a fast expanding global problem related to health in all the
nations. Patients with end stage renal disease prefer kidney transplantation as the
treatment over dialysis due to increased expectancy & quality of life but a costly choice
in developing countries. Therefore, strict adherence to therapy and lifestyle
modification is required for improved graft survival.
Objectives: To determine the effectiveness of nurse led intervention on self care
behaviour, psychological symptoms and quality of life among kidney transplant
recipients.
Materials and Methods: A prospective randomized controlled with time series design
was adopted for the study. The study was carried out according to Consolidated
Standards of Reporting Trials (CONSORT). The consecutive sampling technique was
used to recruit 120 kidney transplant recipients attending transplant clinic who had
completed three months after transplantation and fulfilling the eligibility criteria. The
subjects were randomized to receive either standard care (N=60) or standard care plus
nurse led intervention (N=60) by concealed randomization. The nurse led intervention
included the components of formal health education, relaxation therapy, counselling
and telephonic reinforcement. The intervention comprised of three sessions of 45
minutes each and telephonic reinforcement weekly for two months. Sociodemographic
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and clinical data was collected using structured questionnaire, self care behaviour was
assessed by self care practice checklist and Morisky Green Levine adherence
scale.Psychological symptoms & quality of life were assessed by DASS 21 and WHOQOL
Bref respectively. The outcome measures were assessed at baseline and at six
months and nine months post kidney transplant.
Results: The mean age of participants was 40.05±10.91 years in experimental and
39.45± 10.09 years in control group. Baseline characteristics in the groups were
comparable. There was statistical significant difference in the total self care practice
scores between experimental & control group (p=0.001). Adherence to
immunosuppressive therapy scores showed there was statistical significant difference
between experimental and control group in Posttest 1(p=0.03) and Posttest2 (p=0.001).
There was statistical significant difference for psychological symptoms of stress
