title: Kidney transplant patients' attitudes towards self-management support: A Q-methodological study.
abstract: OBJECTIVE
  Kidney transplant recipients face many self-management challenges. We aimed to identify profiles of attitudes towards self-management support (SMS) shortly after kidney transplantation.
  
  
  METHODS
  Profiles were generated using Q-methodology: In face-to-face interviews participants rank-ordered opinion statements on aspects of SMS according to agreement. Socio-demographic and medical characteristics were assessed using a questionnaire. By-person factor analysis was used to analyze the rankings and qualitative data was used to support choice of profiles. The resulting factors represent clusters of patients with similar attitudes towards SMS.
  
  
  RESULTS
  Forty-three patients (mean age=56; 77% male) participated. Four profiles were identified: (A) transplant-focused and obedient; (B) holistic and collaborative; (C) life-focused and self-determined; and (D) was bipolar. The positive pole (D+) minimalizing and disengaged and the negative pole (D-) coping-focused and needy represent opposing viewpoints within the same profile. Socio-demographic and medical characteristics were not related to profile membership.
  
  
  CONCLUSIONS
  Each profile represents a specific attitude on post-transplant life, responsibility for health and decision-making, SMS needs, and preferences for SMS.
  
  
  CONCLUSIONS
  Patients vary in their attitude, needs and preferences for SMS indicating the necessity of providing personalized support after kidney transplantation. Health professionals should explore patients' SMS needs and adapt support accordingly.
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: j.grijpma@erasmusmc.nl.
authors.forename: J W
authors.initials: JW
authors.lastname: Grijpma
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: m.tielen@erasmusmc.nl.
authors.forename: M
authors.initials: M
authors.lastname: Tielen
authors.affiliation: Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands. Electronic address: a.van.staa@hr.nl.
authors.forename: A L
authors.initials: AL
authors.lastname: van Staa
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: l.maasdam@erasmusmc.nl.
authors.forename: L
authors.initials: L
authors.lastname: Maasdam
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: t.vangelder@erasmusmc.nl.
authors.forename: T
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: s.p.berger@umcg.nl.
authors.forename: S P
authors.initials: SP
authors.lastname: Berger
authors.affiliation: Erasmus MC, Department of Psychiatry, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: j.vanbusschbach@erasmusmc.nl.
authors.forename: J J
authors.initials: JJ
authors.lastname: Busschbach
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: m.g.h.betjes@erasmusmc.nl.
authors.forename: M G H
authors.initials: MG
authors.lastname: Betjes
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: w.weimar@erasmusmc.nl.
authors.forename: W
authors.initials: W
authors.lastname: Weimar
authors.affiliation: Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: e.massey@erasmusmc.nl.
authors.forename: E K
authors.initials: EK
authors.lastname: Massey
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001290:Attitude; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D057240:Patient Preference; D011779:Q-Sort; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Kidney transplantation; Q-methodology; Self-care; Self-management support