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Kim and You: The Effects of an Empowerment Education Program for Kidney Transplantation Patients
Original Article

Journal of Korean Academy of Nursing 2017; 47(4): 445-455.

Published online: 31 August 2017

DOI: https://doi.org/10.4040/jkan.2017.47.4.445

The Effects of an Empowerment Education Program for Kidney Transplantation Patients

Sung Hee Kim1, Hye Sook You2

1Transplantation Center, Chonnam National University Hospital, Gwangju, Korea.

2Department of Nursing, Honam University, Gwangju, Korea.

Address reprint requests to: You, Hye Sook. Department of Nursing, Honam University, 417 Eodeung-daero, Gwangsan-gu, Gwangju 62399, Korea. Tel: +82-62-940-5550, Fax: +82-62-940-5042, basic11@honam.ac.kr

Received 25 August 2016       Revised 10 February 2017       Accepted 19 April 2017

© 2017 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance.

Methods

The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes.

Results

Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher.

Conclusion

Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.

Keywords: Kidney transplantation, Power (Psychology), Uncertainty, Self care, Patient compliance

Figures and Tables

Table 1

Empowerment Education Program for Kidney Transplant Patients

jkan-47-445-i001
Session Theme Content & Activities Methods
1 Program introduction Researcher: Explain the program and its purpose, explain how to complete self-care, and provide overall education regarding post-kidney transplant management. Education, listening, conversation, and linguistic support.
Participant: Introduce members and sign on pledge.
2 Drug administration Researcher: Discuss patient status/condition since the last session, check the daily self-care record, and educate the patient on drug administration times, methods, effects, side effects, etc. Education, listening, conversation, and linguistic support. Raising issues and seeking solutions.
Participant: Share the experience of empowerment practices, acquire new information, and learn about the prescribed medication.
3 Symptoms of rejection and complications Researcher: Discuss patient status/condition since the last session, check the daily self-care record, and educate the patient on the types of rejections, symptoms, treatments, and emergency response methods. Education, listening, conversation, and linguistic support. Raising issues and seeking solutions.
Participant: Share the experience of empowerment practices, acquire new information, and learn about the symptoms of rejection and complications.
4 Nutritional management Researcher: Discuss patient status/condition since the last session, check the daily self-care record, and educate the patient on the types of rejections, symptoms, treatments, and emergency response methods. Education, listening, conversation, and linguistic support. Raising issues and seeking solutions.
Participant: Share the experience of empowerment practices, acquire new information, and learn about the symptoms of rejection and complications.
5 Exercising Researcher: Discuss patient status/condition since the last session, check the daily self-care record, and educate the patient on exercise types, methods, time, and warning signs. Education, listening, conversation, and linguistic support. Raising issues and seeking solutions.
Participant: Share the experience of empowerment practices, acquire new information, and re-recognize the need for exercise.
6 Management of activities of daily living (ADL) Researcher: Discuss patient status/condition since the last session, check the daily self-care record, educate the patient on work life, school life, human contact, going out, travel, quitting smoking/drinking, housework, pet management, pregnancy after kidney transplantation, etc. Education, listening, conversation, and linguistic support. Raising issues and seeking solutions.
Participant: Share the experience of empowerment practices, acquire new information, infection precautions, re-recognize the need for washing hands, and complete the post-test.
Table 2

Homogeneity Test of Characteristics and Dependent Variables between Experimental and Control Group (N=53)

jkan-47-445-i002
Variables Characteristics Exp. (n=25) Cont. (n=28) χ2 or t p
n (%) or Mean±SD n (%) or Mean±SD
Gender Male 13 (52.0) 19 (67.9) 1.39 .239
Female 12 (48.0) 9 (32.1)
Age (yr) 45.48±12.73 46.43±10.45 −0.30 .767
Spouse Yes 18 (72.0) 18 (64.3) 0.36 .572
No 7 (28.0) 10 (35.7)
Education level Middle School 6 (24.0) 2 (7.1) 3.50 .801*
High School 9 (36.0) 10 (35.7)
≥ College 10 (40.0) 16 (57.2)
Occupation Yes 13 (52.0) 18 (64.3) 0.82 .413
No 12 (48.0) 10 (35.7)
Dialysis before transplantation Yes 22 (88.0) 26 (92.9) .658*
No 3 (12.0) 2 (7.1)
Duration of dialysis (months) 38.16±42.88 30.46±33.10 0.74 .465
Duration after surgery (months) 11.44±12.46 16.93±10.21 −1.76 .084
Rejection response Yes 3 (12.0) 8 (28.6) 2.21 .138
No 22 (88.0) 20 (71.4)
Complication Yes 5 (20.0) 7 (25.0) 0.19 .664
No 20 (80.0) 21 (75.0)
Uncertainty 35.52±5.89 38.00±7.07 −0.82 .415
Self-care agency 154.80±15.81 143.82±26.60 1.80 .078
Adherence 80.60±8.62 76.61±9.92 1.56 .126

Exp.=Experimental group; Cont.=Control group.

*Fisher's exact test.

Table 3

Effects of Empowerment Education Program on Uncertainty, Self Care Agency and Compliance (N=53)

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Variables Time Pretest Posttest Post 4 weeks Source F p Difference (Post-Pre) Difference (Post 4weeks-Pre)
Mean±SD Mean±SD Mean±SD Mean±SD t p Mean±SD t p
Uncertainty Exp. (n=25) 35.52±5.89 32.48±6.38 32.60±5.65 G 10.39 .002 −4.04±6.50 −3.84 <.001 −3.92±5.60 −4.51 <.001
Cont. (n=28) 38.00±7.07 39.07±6.10 39.64±5.70 T 3.72 .041 1.07±2.87 1.64±3.12
G×T 14.71 <.001
Self-care agency Exp. (n=25) 154.80±15.81 177.84±20.55 176.80±20.73 G 21.62 <.001 23.04±12.28 5.81 <.001 22.00±13.22 5.84 <.001
Cont. (n=28) 143.82±26.60 141.25±24.75 140.57±24.02 T 36.66 <.001 −2.57±8.19 −3.25±8.61
G×T 61.32 <.001
Compliance Exp. (n=25) 80.60±8.62 88.64±12.07 88.16±11.70 G 19.45 <.001 8.04±10.09 5.07 <.001 7.56±9.96 5.45 <.001
Cont. (n=28) 76.61±9.92 73.60±9.48 72.75±8.83 T 4.46 .038 −3.00±5.03 −3.86±4.70
G×T 27.49 <.001

Exp.=Experimental group; Cont.=Control group; G=Group; T=Time.

Notes

This manuscript is based on a part of the first author's master's thesis from Honam University.

CONFLICTS OF INTEREST The authors declared no conflict of interest.

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