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Volume: 16 Issue: 1 March 2018 - Supplement - 1

FULL TEXT

Effects of Web-Based Educational Intervention on Self-Management in Kidney Recipients

Information technology and the Internet are rapidly becoming effective tools for teaching. Self-management skills are important for adaptation and long-term survival in kidney recipients. Web-based training may help patients develop self-management skills through information access. This literature review aimed to determine the effects of Web-based educational intervention on self-management in kidney recipients. The Internet supports effective health education intervention strategies by providing a learning environment that is always available. Medicine management, routine follow-up, awareness of the signs and symptoms of rejection, infection prevention, self-monitoring, physical activity, and nutrition are important during the posttransplant period. Another important component of achieve-ment in related matters is the competence of individuals with their own self-management. Web-based training is beneficial for appointment follow-up, nutritional adaptation, and treatment of anxiety and depression. Web-based training allows kidney recipients to access information at any time and place; this information promotes proper self-management.


Key words : Renal transplant, Self-management, Web-based health education

Introduction

Communications, information technology, and Internet use are increasing rapidly worldwide, and Turkey is no expception.1 Web-based educational systems that allow Internet surfing are among the most effective.2 Kidney recipients who reside in regions without easy access to health care professionals require the availability of Web-based training.

Self-management is defined as being capable of participating actively in one's own care, including the use of behavioral and psychologic strategies and treatments. It is known that education is important for the acquisition of self-management.3 This literature review aimed to highlight the effects of Web-based educational intervention on self-management in kidney recipients.

Materials and Methods

Google Scholar, PubMed, and EBSCOhost were searched in both English and Turkish, using the keywords "web-based education," "kidney/renal transplantation," "distance education," and "kidney transplant." Relevant studies are discussed.

Results and Discussion

According to the 2016 report on Information and Communication Technology by the Turkish Statistical Institute, overall Internet usage reached 93.7% and household Internet usage reached 76.3%.4 These data show that Internet use has become prevalent. Therefore, individuals may prefer online training materials for health education. The content of online training materials must be comprehensible and appropriate for the educational status of specific individuals.5

Individuals with chronic diseases need support for the disease, treatment options, social support, decision-making, diet, exercise, and behavioral change. Computer-based programs can be used for online support, decision-making on health-related issues, evaluating behavioral change, and meeting the needs of individuals.6 It is known that patients with chronic renal failure lack knowledge thatmay be life-threatening. Information is essential forself-management in patients with chronic disease. Online tools enable patients worldwide to com-municate with each other through synchronous or asynchronous networks. Web-based training is also important for social support. Internet-based educational support can also be downloaded and printed to share with patients.7

Kidney transplant is a treatment that positively affects quality of life. However, challenges in adapting to immunosuppressive treatment increase the need for recipient and caregiver information.4 The increased need for information and responsibility cause patients and their families to have difficulty adapting and maintaining treatment regimens.8 Patient decisions and behaviors affect their health status during the pre- and posttransplant process.9 Accordingly, communication technologies can improve health care.10

The Internet provides affordable, effective health interventions regardless of physical access to a health care provider. Medical status and adaptability may decrease participation in Web-based interventions; however, reminder e-mails may motivate patients during the educational intervention process.11 A computer-based system allows for both self-learning and instructor-led e-learning, either individually or in a group, via synchronous or asynchronous communication. E-learning can employ blended learning methods that include both a specific training environment and distance learning.12 Web-based learning is accepted as an effective tool for information sharing.13

Patients must take medication(s) at the same time every day, have regular follow-up, be aware of rejection signals,9 monitor side effects, prevent infections, self-monitor, and engage in physical activity and nutritional self-management after transplant.14,15 After transplant, patients may experience setbacks due to mental health, quality of life, and medication management; these are important issues for individuals without easy access to transplant care providers. Web-based training is useful for follow-up appointments and nutritional adaptation. Internet-based training has positive effects on patients and caregivers with anxiety and depression.16 Web-based training is preferred because of its ubiquitous availability, independent of time and location. It can reach many patients at once and is cost-effective.17

Conclusions

Information and training have not been sufficient for kidney recipients in in-home care or those required to remain at home because of postdischarge requirements. Web-based training for kidney recipients can allow recovering patients to access health care information at will and can be useful for self-management.


References:

  1. Turkey Statistical Institute. Information and Communication Technology (ICT) Usage in Households and by Individuals; 2016. http://www.tuik.gov.tr/PreHaberBultenleri.do?id=21779. Accessed May 15, 2017.

  2. Fredericks S, Martorella G, Catallo C. A systematic review of web-based educational interventions. Clin Nurs Res. 2015;24(1):91-113.
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  3. Moore SM, Schiffman R, Waldrop-Valverde D, et al. Recommendations of common data elements to advance the science of self-management of chronic conditions. J Nurs Scholarsh. 2016;48(5):437-447.
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  4. Weng L-C, Dai Y-T, Wang Y-W, Huang H-L, Chiang Y-J. Effects of self-efficacy, self-care behaviours on depressive symptom of Taiwanese kidney transplant recipients. J Clin Nurs. 2008;17(13):1786-1794.
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  5. Y?ld?z T. Current methods used in surgery patient education: not disease centered, patient centered education. Clin Exp Health Sci. 2015;5(2):129-133.

  6. Murray E, Burns J, See Tai S, Lai R, Nazareth I. Interactive health communication applications for people with chronic disease. In: Murray E, ed. Cochrane Database System Review. Chichester, UK: John Wiley & Sons, Ltd; 2005:CD004274.
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  9. Pizzuto D. Adherence program launched for kidney recipients and caregivers. CANNT J. 2010;20(4):13.

  10. Nogueira PC, de Carvalho Nagliate P, de Godoy S, Rangel EML, Trevizan MA, Mendes IAC. Technology use for health education to caregivers: an integrative review of nursing literature. Appl Nurs Res. 2013;26(3):101-104.
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  11. Schweier R, Romppel M, Richter C, Grande G. Dissemination strategies and adherence predictors for web-based interventions-how efficient are patient education sessions and email reminders? Health Educ Res. 2016;31(3):384-394.
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  12. Çoban S. Uzaktan ve teknoloji destekli e?itimin geli?imi. http://inet-tr.org.tr/inetconf17/bildiri/26.pdf. Accessed March 3, 2017.

  13. Goede P, Frasier L, Thraen I. An image-centric, web-based, telehealth information system for multidisciplinary clinical collaboration. In: Lazakidou A, ed. Web-Based Applications in Healthcare and Biomedicine. Boston, MA: Springer; 2010:77-100.
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  14. Kobus G, Małyszko J, Małyszko J, Puza E, Bachorzewska-Gajewska H, Myśliwiec M. Compliance with lifestyle recommendations in kidney allograft recipients. Transplant Proc. 2011;43(8):2930-2934.
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  15. Akyolcu N. Patient education in renal transplantation. J Ren Care. 2002;28(4):176-179.
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  16. Dew MA, Goycoolea JM, Harris RC, et al. An Internet-based intervention to improve psychosocial outcomes in heart transplant recipients and family caregivers: development and evaluation. J Heart Lung Transplant. 2004;23(6):745-758.
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  17. Gökçe AT. Küreselle?me sürecinde uzaktan e?itim. Ziya Gökalp E?itim Fakültesi Derg. 2008;11:1-12.


Volume : 16
Issue : 1
Pages : 117 - 118
DOI : 10.6002/ect.TOND-TDTD2017.P9


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From the Surgical Nursing Department, Akdeniz University Faculty of Nursing, Antalya, Turkey
Acknowledgements: The authors declare that they have no sources of funding for this study, and they have no conflicts of interest to declare.
Corresponding author: Çi?dem Çetin, Akdeniz Üniversitesi, Dumlup?nar Bulvar? 07058, Kampus Antalya, Turkey
Phone: +90 242 310 29 88
E-mail: cgdmctn07@gmail.com