Indiana University-Purdue University Indianapolis (IUPUI) / Poor long-term kidney transplant outcomes are a significant problem in the U.S.
Interventions must focus on preserving allograft function by managing modifiable risk
factors. An instrument capable of identifying problems with post-kidney transplant
self-management behaviors may enable the design and testing of self-management
interventions. This study’s purpose was to test the psychometric properties of the new
Kidney Transplant Self-Management Scale (KT–SM). The Zimmerman framework
adapted for kidney transplant self-management guided the cross-sectional study. A total
of 153 kidney recipients recruited from Facebook® completed the Self-Efficacy for
Managing Chronic Disease (SEMCD), Patient Activation Measure (PAM), Kidney
Transplant Questionnaire (KTQ), and KT–SM Scale instruments via a REDCap® survey.
Most participants were female (65%), White (81.7%), and middle-aged (M = 46.7; SD =
12.4 years) with a history of dialysis (73%) and received a kidney transplant an average
of 6.58 years previous (SD = 6.7). Exploratory factor analysis results supported the
16-item KT–SM Scale as a multidimensional scale with five domains with loadings
ranging between .39 and .89: medication adherence, protecting kidney, cardiovascular
risk reduction, ownership, and skin cancer prevention. Internal consistency reliability for
the total scale (Cronbach’s α = .84) and five domains ranged from .71 to .83. The total
and domains were positively correlated, ranging from r = .51 to .76, p = .01.
Criterion-related validity was evidenced by significant correlations of KT–SM and
domains with SEMCD (r =.22 to .53, p = .01), PAM (r = .31 to .52, p = .01), and the overall KTQ (r = .20 to .32, p = .01) except for one KT–SM domain: protecting kidney.
Construct validity was evaluated using multivariate regression analysis. The linear
combination of age, patient activation, and self-efficacy explained 45% of the variance in
KT–SM behaviors; 47% of the variance in KTQ (measuring quality of life) was predicted
by age, comorbidity, and self-efficacy. These findings provide beginning evidence of
reliability and validity for the newly developed KT–SM scale. Instruments like this may
provide a means to capture the self-management behaviors of the kidney transplant
population, which is critical for future work on interventions.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/17246 |
| Date | 03 April 2018 |
| Creators | Chung, Shu-Yu |
| Contributors | Hacker, Eileen, Jones, Josette, Ellis, Rebecca Bartlett, Rawl, Susan, Bakas, Tamilyn |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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