Self-management Status And Influencing Factors Of Liver Transplant Recipients

Objective:(1)To describe the current status of self-management among liver transplant recipients;and(2)To explore the influencing factors of self-management among liver transplant recipients from the aspects of personal coping,close relations,context,and culture based on the pyramid model of social-environmental support so as to provide a theoretical basis for intervention of self-management among liver transplant recipients.Methods:From April to June 2017,a cross-sectional survey was conducted in the liver transplant follow-up center at Beijing You An Hospital,Capital Medical University.A total of 244 liver transplant recipients were recruited using convenient sampling and were investigated using the general questionnaire,Self-management Questionnaire for Liver Transplant Recipients,Self-efficacy for Managing Chronic Disease 6-Item Scale,Hospital Anxiety and Depression scales,Sense of Coherence-13,Brief Illness Perception Questionnaire,and the Chronic Illness Resources Survey.SAS 9.30 statistical software was used for the statistical analysis.The statistical analysis included descriptive analysis,Spearman correlation analysis,non-parametric test,and multiple stepwise regression analysis.Results:(1)The median time of exercise was 180 minutes per week(P25=75minutes,P75=240 minutes);and the median scores of subscales of self-management were 1.40(P25=0.60,P75=2.A0)for cognitive symptom management,2.00(P25=1.25,P75=3.00)for the communication with the doctor,4.03(P25=3.59,P75=4.38)for the lifestyle management,4.50(P25=3.88,P75=4.75)for disease control,3.88(P25=3.38,P75=4.50)for diet,4.25(P25=3.63,P75=4.75)for sanitation,and 3.40(P25=2.80,P75=4.00)for activity.(2)Univariate analysis showed that age,gender,place of residence,education level,monthly family income,post-transplant time,frequency of follow-up,self-efficacy,cognition of disease,anxiety,depression,sense of coherence,support from health care team,family and friend support,self-adjustment,neighborhood support,community resources,organizational support,media and policy resources were related to one or more dimensions of self-management.(3)Multivariate analysis showed that organizational support and recipients' illness perception were influencing factors of exercise self-management and explained 12.9%of the variance.For the communication with doctors,self-adjustment,post-transplant time and monthly family income were the main influencing factors and explained 12.3%of the variance.For the cognitive symptom management,support from health care team was the main influencing factor and explained 2.5%of the variance.For the disease control,media and policy resources,recipients' illness perception,the time after transplantation were the main influencing factors and explained 24.2%of the variance.For the diet self-management,family and friends support,self-efficacy,recipients' illness perception,media and policy resources and self-adjustment were the main influencing factors and explained 38.5%of the variance.For the sanitation self-management,family and friend support,gender,depression,media and policy resources,self-adjustment were the main influencing factors and explained 31.4%of the variance.For activity self-management,self-efficacy,media and policy resources,organizational support,self-adjustment,gender,and place of residence were the main influencing factors and explained 41.6%of the variance.Conclusion:The different dimensions of self-management among liver transplant recipients are at different level,and disease control,diet,sanitation and activity are at a medium or higher level,while communication with physicians,cognitive symptoms management and exercise management are at a low level.The influencing factors of self-management among liver transplant recipients are multifaceted,including personal coping,close relations,environmental and cultural factors.It is suggested that the medical staff should take corresponding measures from the different aspects to improve liver transplantation recipient's self-management.