Evaluation of an Individualized Education before Discharge and Follow-up Telephone Consultation on Self-efficacy for Kidney Transplant Patients

신장이식환자의 자기효능전략을 이용한 퇴원 시 개별교육과 추후 전화상담의 효과

  • Received : 2015.10.26
  • Accepted : 2015.11.02
  • Published : 2015.11.30


Purpose: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. Methods: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and ${\chi}^2$-test using SPSS WIN 20.0. Results: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. Conclusion: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.


Medication;Diet;Compliance;Kidney transplantation;Self-efficacy


  1. Kim SL, Kim YS, Kim MS, Park EC, Jeon KY, Son SY, et al. A renal transplantation and hemodialysis cost-utility analysis in patients with end-stage renal disease. The Journal of the Korean Society for Transplantation. 2010;24(3):173-181.
  2. Kang SG, Kim W, Lee S. Nephrology. 2nd ed. Seoul: Korea Medical Book Publisher; 2010. p. 149-162.
  3. Kim MH, Lim MS, Kwon OJ, Kang CM. Comparison of quality of life between kidney transplant patients and dialysis patients. The Journal of the Korean Society for Transplantation. 2009;23(1):65-70.
  4. Korean Network for Organ Sharing. Annual report of transplant 2013 [Internet]. Seoul: Korean Network for Organ Sharing; 2013 [cited 2015 February 1]. Available from:
  5. Kim HC, Cho WH. Renal transplantation. Seoul: Koonja; 2000. p. 43-60.
  6. Kobus G, Malyszko J, Malyszko JS, Puaz E, Bachorzewska-Gajewska H, Mysliwiec M. Compliance with lifestyle recommendation in kidney allograft recipients. Transplant Proceedings. 2011;43(8):2930-2934.
  7. Hwang YH, Choe MA. Study on the compliance of kidney transplantation recipients. Korean Society of Critical Care Nursing. 2011;4(2):15-25.
  8. Hwang EA, Jang MH, Kwak CH, Han SY, Park SB, Kim HC, et al. The changes of graft survival and causes of graft failure after kidney transplantation. The Journal of the Korean Society for Transplantation. 2011;25(1):22-30.
  9. Gheith OA, El-Saadany SA, Abuo Donia SA, Salem YM. Compliance of kidney transplant recipients to the recommended life style behaviors: Single centre experience. International Journal of Nursing practice. 2008;14(5):398-407.
  10. Williams NC, Tong A, Howard K, Chapman JR, Craig NC, Wong G. Knowledge, beliefs and attitudes of kidney transplant recipients regarding their risk of cancer. Nephrology. 2012;17(3):300-306.
  11. Janet AB, Paul R, Mark M, Juan CM, Robert CP. Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review. Transplantation. 2004;77:769-776. 0000110408.83054.88
  12. Sim MK, Son SY. The effects of an individual educational program on self-care knowledge and self-care behavior in kidney transplantation patients. Journal of East-West Nursing. 2012;18(1):9-17.
  13. Kim MS. Knowledge and compliance of kidney transplant patients [master thesis]. Daegu: Kyungpook National University; 1995. p.1-44
  14. McPake D, Burnapp L. Caring for patients after kidney transplantation. Nursing Standard. 2009;23(19):49-57.
  15. Robinsons JK, Turrisi R, Mallett KA, Stapleton J, Boone SL. Kim N, et al. Efficacy of an educational intervention with kidney transplant recipients to promote skin self-examination for squamous cell carcinoma detection. Archives Dermatology. 2011;147(6):689-695.
  16. Urstad KH, Oyen O, Andersen MH, Moum T, Wahl AK. The effect of an education intervention for renal recipients: A randomized controlled trial. Clinical Transplantation. 2012;26(3):246-253.
  17. Bae GE. The effect of telephone counseling program on stress and self care in kidney transplantation patients [master thesis]. Incheon: Inha University; 2005. p.1-73
  18. Dew MA, Kormos RL, Roth LH, Murali S, DiMartini A, Griffith BP. Early post-transplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation. The Journal of Heart and Lung Transplantation. 1999;18(6):549-562.
  19. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change, Psychological Review. 1977;84(2):191-215.
  20. Chung SM. The relationships of family support, self-efficacy and self-care compliance among kidney transplantation patients [master thesis]. Seoul: Yonsei University; 2004. p. 1-65
  21. Weng LC, Dai YT, Huang HL, Chiang YJ. Self-efficacy, self-care behaviors and quality of life of kidney transplant recipients. Journal of Advanced Nursing. 2010;66(4):828-838.
  22. An JH. The effect of the self efficacy promotion and exercise training program of kidney transplant recipients. Journal of Korean Academy of Nursing. 2000;30(5): 223-232.
  23. Lee SJ, Park HS, Han JH, Kim HJ, Seo MW, Choe EH, et al. Effects of an individualized educational program on knowledge, compliance and physiologic parameters in non-compliant hemodialysis patients. Journal of Korean Clinical Nursing Research. 2009;15(3):5-16.
  24. Lin SY, Fetzer SJ, Lee PC, Chen CH. Predicting adherence to health care recommendations using health promotion behaviors in kidney transplant recipients within 1-5 years post-transplant. Journal of Clinical Nursing. 2011;20(23-24):3313-3321.
  25. The Korean Society of Transplantation. Renal transplantation and new life. Seoul: Medical Culture History; 2008. p. 104-121.
  26. Malanda UL, Welschen LM, Riphagen II, Dekker JM, Niipels G, Bot SD. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin[internet]. New Jersey: Cochrane Database Systematic Review; 2012 [cited 2013 April 1]. Available from:
  27. Uhliq K, Balk EM, Patel K, Ip S, Kitsios GD, Haynes SM, et al. Self-measured blood pressure monitoring: comparative effectiveness [Internet]. Rockville: Agency for Health Research and Quality; 2012 [cited 2013 April 1]. Available from:
  28. Bains M, Munir F, Yarker J, Bowley D, Thomas A, Armitage N, et al. The impact of colorectal cancer and self-efficacy beliefs on work ability and employment status: A longitudinal study. European Journal of Cancer Care. 2012;21(5):634-641.
  29. Nouwen A, Ford T, Balan AT, Twisk J, Ruggiero L, White D. Longitudinal motivational predictors of dietary self-care and diabetes control in adults with newly diagnosed type 2 diabetes mellitus. Health Psychology. 2011;30(6):771-779.
  30. Sampaio R, Pereira MG, Joao C, Winck JC. Obstructive sleep apnea representations, self-efficacy and family coping regarding APAP adherence: a longitudinal study. Psychology, Health & Medicine. 2014;19(1):59-69.

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