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Motivators and Barriers to Self-Management among Kidney Transplant Recipients in Selected State Hospitals in South Africa: A Qualitative Study

Hillary Ndemera and Busisiwe Bhengu

Background: Kidney transplantation is the most recommended treatment modality for many patients with end stage renal disease. Kidney transplant recipients need integrated care to provide continuous and coordinated care from pre-transplant to post-transplant phase. Kidney transplant recipients are motivated to adhere to the health care recommendations to improve on the graft life. However, to effectively implement strategies that enhance adherence, it is important to understand the motivators and barriers to self-management among kidney transplant recipients. Objectives: To explore motivators and barriers to selfmanagement among kidney transplant recipients in selected state hospitals in South Africa. Methods: A qualitative case study design was adopted. Purposive sampling method was used to select the study participants. Data was collected through semi-structured interview schedule developed from in-depth literature review. Data was analyzed through thematic template approach. Thematic codes were created based on central research questions during data collection and analysis. Results: The motivators included kidney transplant recipient, physiological, psychological, different support systems and healthcare system related factors. The barriers included kidney transplant recipient, physiological, psychological, healthcare system and socioeconomic status related factors. Conclusion: Exploration of motivators and barriers to selfmanagement among kidney recipients resulted in identification of gaps in kidney transplant management. Understanding the motivators and barriers among kidney transplant recipients towards self-management may allow healthcare professionals to tailor interventions. In addition, the study would inform strategies to promote self-management and behavioral change among kidney transplant recipients towards management. Furthermore, the specific interventions may contribute to improvement of long-term graft survival post kidney transplantation, enhancing improved health status and quality of life.