Predictors of self-care in kidney transplant patients according to preoperative dialysis: A comparative study

Preemptive kidney transplantation (PKT) is associated with reduced dialysis-related morbidity and improved graft survival, which has led to an increase in the prevalence of PKT. The distinct clinical pathways of PKT and non-preemptive kidney transplantation (NPKT) patients may affect their ability to perform self-care, a key factor in post-transplant recovery. However, there is ongoing controversy regarding which group demonstrates better self-care abilities, highlighting the need to explore the factors influencing self-care in each group.

This study aims to identify and compare predictors of self-care in PKT and NPKT groups.

We collected data from 209 KT recipients, consisting of 101 PKT and 108 NPKT patients, using self-administered questionnaires. These questionnaires assessed general and disease-specific characteristics, stress, social support, and self-care behaviors. Data were analyzed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis.

The study identified significant predictors of self-care among both PKT and NPKT patients. For PKT patients, marital status (β = .19, p = .033) and family support (β = .28, p = .006) are key predictors of self-care, with those having spousal support and strong family networks reporting better self-care levels. Conversely, in NPKT patients, significant predictors of self-care included marital status (β = .31, p = .001), employment status (β = .29, p = .007), post-transplantation duration (less than 36 month) (β = -.22, p = .015), post-transplantation duration (36-72 month) (β = -.33, p = .001), and stress levels (β = -.20, p = .028).

The study provides valuable insights into the predictors of self-care based on preoperative dialysis status, illustrating distinct predictors between the growing population of PKT and NPKT patients. These findings emphasize the need for personalized nursing strategies to enhance post-transplant self-care, tailored to individual patient characteristics.