Self-efficacy, self-care behaviours and quality of life of kidney transplant recipients

Aim: This paper is a report of an exploration of the effects of self-efficacy and different dimensions of self-management on quality of life among kidney transplant recipients. Background: Self-efficacy is an important factor influencing self-management. Patients with higher self-efficacy have better self-management and experience better quality of life. Self-efficacy influences the long-term medication-taking behaviour of kidney transplant recipients. Method: A longitudinal, correlational design was used. Data were collected during 2005-2006 with 150 adult kidney transplant recipients on self-efficacy, self-management and quality of life using a self-efficacy scale, self-management scale and the Medical Outcomes Scale SF-36 (Chinese), respectively. Relationships among variables were analysed by path analysis. Results: Participants with higher self-efficacy scored significantly higher on the problem-solving (β = 0·51), patient-provider partnership (β = 0·44) and self-care behaviour (β = 0·55) dimensions of self-management. Self-efficacy directly influenced self-care behaviour and indirectly affected the mental health component of quality of life (total effect = 0·14). Problem-solving and partnership did not statistically significantly affect quality of life. Neither self-efficacy nor self-management had any effect on the physical health component of quality of life. Conclusion: Transplant care teams should incorporate strategies that enhance self-efficacy, as proposed by social cognitive theory, into their care programmes for kidney transplant recipients. Interventions to maintain and improve patients' self-care behaviour should continue to be emphasized and facilitated. Support to enhance patients' problem-solving skills and the partnership of patients with health professionals is needed.