关键词: 肾移植；自我管理；自我管理支持；自我效能；健康促进模式；结构方程

Abstract: Objective: To investigate the current situation of self-management among kidney transplant recipients, and analyze the relationships of interactions among influencing factors, so as to provide references for medical staff in developing self-management programs for kidney transplant recipients. Methods: Using convenience sampling method, 265 kidney transplant recipients who were followed up by outpatient departments in three tertiary grade A hospitals in Beijing and Changsha from October 2020 to March 2021 were enrolled. The patients were investigated using the self-designed general data questionnaire, the Chronic Disease Self-efficacy Scale, the Kidney Transplant Recipient Self-management Support Scale, the Kidney Transplant Recipient Self-management Scale, and the Hospital Anxiety and Depression Scale. The structural equation model was constructed using AMOS 24.0 software. Results: The scores of self-management were 95.00 (84.00, 103.00). The structural equation model showed that self-management support (β=0.572, P<0.001), self-efficacy (β=0.176, P=0.004) and education level (β=0.150, P=0.015) had a direct effect on self-management, and depression indirectly affected self-management through self-management support (β=-0.159, P<0.001), and economic burden indirectly affected self-management through self-efficacy (β=-0.021, P=0.011). Conclusion: The self-management level of kidney transplant recipients is at a good level. Clinical staff can improve the self-management support level and self-efficacy of patients by formulating targeted intervention measures.

Key words: kidney transplantation; self-management; self-management support; self-efficacy; health promotion model; structural equation