Impact of Reinforcement of Post-Renal Transplant Education on Patient Understanding of Lifestyle Changes

Background: Post-renal transplant education plays a pivotal role in the success of renal transplantation by empowering recipients with the understanding and knowledge needed to manage their renal health post-transplantation. Evidence indicates that patients who lack an understanding of immunosuppressive medication, dietary restrictions, and signs of graft rejection are at an increased risk of complications, hospitalization, and/or loss of graft. Even without specific complications, inadequate education and non-adherence to prescribed plans remain significant barriers to achieving optimal patient outcomes. In a large southeastern medical center outpatient transplant clinic, it was estimated that 20-25% of the patients were confused about the required lifestyle changes they needed to make. With the lack of educational curriculum reinforcement in post-renal transplant patients, a higher number of post-renal transplant rejections occur within the first three months post-transplantation. There is no transplant educator in the outpatient clinic, resulting in little to no reinforcement of the educational curriculum the recipients received when they were inpatients. During post-renal transplant clinic visits, it was noted that many patients were overwhelmed with information they received immediately post-operatively. Clarification of lab values, medications, and diet considerations needed to be readdressed. Many of the transplant recipients had been on dialysis for years and it was evident that they were struggling to comprehend this new way of life.
Objective: The purpose of this project was to improve renal transplant recipients’ health and lifestyle knowledge through targeted reinforcement of post-renal transplant education.
Methods: Within three months after the inpatient education phase of renal transplant, the kidney understanding tool (K-TUT) 25-question survey was administered to renal transplant recipients to assess their knowledge of post-renal transplant health. The survey took approximately 30 minutes to complete. Following the survey, patients received written educational material including targeted information based on the participant’s K-TUT score and an online presentation via Zoom. After the educational sessions, the K-TUT survey was repeated to evaluate the intervention.
Demographic information: The target population was patients over the age of 21 years who received a kidney transplant within three months. 33 patients were screened; 13 completed all phases of the project.
Analysis: Pre- and post-intervention scores were analyzed for changes in understanding and level of confidence in initiating lifestyle changes. Descriptive and inferential statistical tests (T-test and Pearson’s correlation) were used to analyze pre- and post-survey scores.
Results: The pre-survey scores showed a mean of 76.6, and post-survey scores had a mean of 83.7, with a p-value of 0.001. The results indicate that renal transplant patients who received reinforcement of education showed an improvement in knowledge to make essential lifestyle changes.
Conclusion: The educational intervention successfully reinforced renal health knowledge for post-renal transplant recipients who were less than three months post-transplantation. The clinic nurses could incorporate reinforcing information that was indicated on the K-TUT survey.