Effect Of Case Management Model On Health-related Quality Of Life In Kidney Transplant Recipients

ObjectiveTo explore the effect of kidney transplantation case management intervention on the health-related quality of life of kidney transplant recipients.Methods1.This study is a kind of experimental study.96 renal transplant recipients who met the inclusion criteria and were treated in a kidney transplant department of a tertiary hospital in Zhengzhou from August 2018 to November 2019 were included in the research objects.The recipients were randomly divided into intervention group and control group with 48 cases according to random number table method.The control group implemented routine nursing intervention and follow-up management,and the intervention group implemented case management intervention based on the control group.The case management team conducts case management interventions on the recipients according to the six steps of evaluation,planning,implementation,coordination,supervision,and evaluation,which involve medication,self-monitoring,diet,lifestyle,complications,and psychology.2.Before intervention,1 month,3 months and 6 months after discharge from hospital,used "Quality of life of Renal Transplant Recipients","Renal Transplant Recipients’ Compliance questionnaire",and "Self-efficacy Scale for Chronic","Renal Transplant Recipients’ self-management scale" measures the quality of life,compliance,self-management ability of the recipient,and statistics of the incidence of infection and related clinical indicators.3.Statistical analysis was performed using SPSS 21.0 statistical software.X±S,frequency and constituent ratio for statistical description.we used chi-square test to analyze qualitative data and used T test,non-parametric test,repeated measurement analysis of variance to analyze quantitative data.The test level is specified as α=0.05.ResultsIn all of 6 kidney transplant recipients were lost during this study,3 in the intervention group and 3 in the control group.A total of 90 effective interventions were made,Sample loss rate is 6.25%.1.There were no statistically significant differences in the sociodemographic data,disease-related data and quality of life,treatment compliance,chronic disease self-efficacy,kidney transplantation self-management capacity and related clinical indicators of the two groups of recipients.(P>0.05).2.Comparison of total quality of life scores and dimensions of the two groups of recipients:The upward trend of quality of life of the intervention group was higher than the control group,and the difference was statistically significant(P<0.05).The repeated measurement analysis of variance showed that the time effect was statistically significant differences(F=227.938,179.307,170.621,112.047,150.104,P<0.001);the grouping effect is statistically significant differences(F=74.239,33.185,43.713,6.189,83.477,P<0.05);There is an interaction between the time effect and the grouping effect(F=14.225,28.583,12.841,8.086,16.090,P<0.001).3.Comparison of the treatment compliance of the two groups of recipients:The treatment group’s treatment compliance score in the intervention group was higher than that control group,and the difference was statistically significant(P<0.001).Repeated measurement analysis of variance showed that the two groups of recipients at different time points Treatment compliance score,time effect was statistically significant(F=129.309,P<0.001);grouping effect was statistically significant(F=32.267,P<0.001);There was an interaction between the time effect and the grouping effect(F=37.517,P<0.001).4.Comparison of self-efficacy and self-management ability between the two groups of recipients:the total increase in self-efficacy and self-management ability of the intervention group is higher than that of the control group,and the difference was statistically significant(P<0.05);repeated measurement analysis of variance results show:The self-efficacy score and the total score of self-management ability of the two groups of recipients at different time points,the time effect was statistically significant(F=77.302,P<0.001;F=257.651,P<0.001);the grouping effect was statistically significant(F=10.840,P<0.001,F=68.016,P<0.001);There was an interaction between the time effect and the grouping effect(F=9.734,P<0.05;F=102.045,P<0.001).5.Comparison of the incidence of infection between the two groups of recipients:There was a statistically significant difference in the incidence of the infections between two groups of recipients(χ2=7.389,P=0.025).6.Comparison of clinical indicators between the two groups of recipients:SBP(t=-2.127,P=0.036),DBP(t=-2.621,P=0.011),Glu(t=-2.531,P=0.013),TC(t=-2.741,P=0.008),the difference was statistically significant,the intervention group was significantly improved compared with the control group;BMI(t=-1.700,P=0.093),Scr(t=-1.737,P=0.086)The difference was not statistically significant.ConclusionsCase management interventions can improve the quality of life of kidney transplant recipients,effectively improve recipients’ treatment compliance,self-efficacy,and self-management capabilities,reduce the incidence of infection,and improve related clinical indicators.