Exploring health literacy and self-management after kidney transplantation: A prospective cohort study.

OBJECTIVE

Investigate the influence of health literacy and self-management on complications, kidney function and graft failure after kidney transplantation.

METHODS

We included patients who received a kidney transplant between May 2012 and May 2013 and monitored outcomes until December 2018. Health literacy was measured using the Newest Vital Sign and self-management using the Partner in Health scale (before discharge, and after 6 and 12 months). Subscales are aftercare & knowledge, coping, recognition and management of symptoms, healthy lifestyle. Complications were categorized as rejection, viral infections, and bacterial infections. Kidney function was measured using eGFR and graft survival using days until failure.

RESULTS

We included 154 patients. Higher health literacy at baseline and at 12 months was related to more viral infections (p = 0.02; p < 0.01). Lower 'coping' at baseline was related to more bacterial infections (p = 0.02). Higher 'after-care and knowledge' at 6 months (p < 0.01), and 'recognition and management of symptoms' at 6 months were associated with lower graft failure (p < 0.01).

CONCLUSION

Health literacy did not influence kidney transplant related outcomes. Higher knowledge and management of symptoms were related to lower graft failure.

PRACTICE IMPLICATIONS: Self-management support is a key focus for health care providers in the multidisciplinary team.