Factors influencing health self-management in adherence to care and treatment among the recipients of liver transplantation

Malihe Sadat Moayed; Abbas Ebadi; Masoud Khodaveisi; Mohssen Nassiri Toosi; Ali Reza Soltanian; Mahnaz Khatiban

doi:10.2147/PPA.S180341

Factors influencing health self-management in adherence to care and treatment among the recipients of liver transplantation

Patient Prefer Adherence. 2018 Nov 16:12:2425-2436. doi: 10.2147/PPA.S180341. eCollection 2018.

Authors

Malihe Sadat Moayed¹, Abbas Ebadi², Masoud Khodaveisi³, Mohssen Nassiri Toosi⁴, Ali Reza Soltanian⁵, Mahnaz Khatiban⁶

Affiliations

¹ Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
² Nursing Education, Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran.
³ Chronic Diseases (Home Care) Research Center, Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran.
⁴ Internal Medicine, Hepatologist, Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
⁶ Mother and Child Care Research Center, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran, mahnaz.khatiban@gmail.com.

Abstract

Introduction: Liver transplantation is the global treatment of end-stage liver diseases. Since the patients' survival rate has been improved, the patient may experience reductions in physical, cognitive, and psychosocial functions after liver transplantation influencing their adherence to care and treatment. The transplant survival is complex and patients' adherence to care and treatment should be considered when health care providers make decisions regarding treatment. This qualitative study aimed to explore factors influencing health self-management in adherence to care and treatment among the recipients of care and treatment.

Methods: In this study, 23 interview sessions were carried out with a total 18 patients, 2 family members and 3 transplantation team members from May to November 2017. The patients were selected using the purposive method from both genders, with a various age range and initial diseases leading to liver transplantation, and time passed from liver transplantation. A semi-structured interview guide was developed based on literature review and pilot interviews. The participants were asked to describe their experiences of self-management behaviors in adherence to treatment and care. The data were analyzed using a conventional content analysis method and managing via the MAXQDA-10 software.

Results: Two themes were developed during data analysis as "self-regulation" and "self-care". "Self-regulation" consisted of "intentionally changing", "positively thinking", "information seeking", "problem-solving", "past knowledge transferring", and "self-controlling". "Self-care" had three sub-themes "shift to independence", "vigilance", and "self-care support".

Conclusion: The participants perceived the health self-management in adherence to care as a set of factors related to "self-regulation" and "self-care" behaviors. "Self-regulation" is required to create a balance in life. Also, "self-care" efforts can help with maintaining and improving patients' health.

Keywords: adherence; compliance; liver transplantation; qualitative research; recipient; self-care; self-management; self-regulation; treatment.