Exploring health literacy and self-management after kidney transplantation: A prospective cohort study

Louise Maasdam*, Reinier Timman, Monique Cadogan, Mirjam Tielen, Marleen C. van Buren, Willem Weimar, Emma K. Massey

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
23 Downloads (Pure)


Objective: Investigate the influence of health literacy and self-management on complications, kidney function and graft failure after kidney transplantation. Methods: We included patients who received a kidney transplant between May 2012 and May 2013 and monitored outcomes until December 2018. Health literacy was measured using the Newest Vital Sign and self-management using the Partner in Health scale (before discharge, and after 6 and 12 months). Subscales are aftercare & knowledge, coping, recognition and management of symptoms, healthy lifestyle. Complications were categorized as rejection, viral infections, and bacterial infections. Kidney function was measured using eGFR and graft survival using days until failure. Results: We included 154 patients. Higher health literacy at baseline and at 12 months was related to more viral infections (p = 0.02; p < 0.01). Lower ‘coping’ at baseline was related to more bacterial infections (p = 0.02). Higher ‘after-care and knowledge’ at 6 months (p < 0.01), and ‘recognition and management of symptoms’ at 6 months were associated with lower graft failure (p < 0.01). Conclusion: Health literacy did not influence kidney transplant related outcomes. Higher knowledge and management of symptoms were related to lower graft failure. Practice implications: Self-management support is a key focus for health care providers in the multidisciplinary team.

Original languageEnglish
Pages (from-to)440-446
Number of pages7
JournalPatient Education and Counseling
Issue number2
Publication statusPublished - Feb 2022

Bibliographical note

We thank Mirjam Laging for support conducting the Cox analysis and Judith Kal for data management support.

Publisher Copyright:
© 2021 The Authors


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