Page 55 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint

Patient Acceptance of a Self-Management Support System 53
System description
Patients used a blood pressure meter and a creatinine device at home to measure their blood pressure and kidney function according to a fixed schedule. They were instructed to enter the measured values into a specially designed website called MijnNierInzicht (MNI), which was designed by the LUMC with help from the Dutch Organization for Applied Scientific Research (TNO) and maintained by company Bonstato. After entering their measured values, the website provided patients with an overview of their measurement history, an evaluation of their current renal function, and instructions for further actions, which could be: to continue their regular schedule, to conduct an additional measurement, or to contact the hospital. Besides the advice and monitoring function, the system included online learning modules (eLearning) providing relevant information, such as bodily functions, renal transplantation, and self-management. The system further allowed patients to record their weight, body temperature, and scheduled face-to-face and phone appointments with their doctors. The measuring devices, MNI website, and eLearning formed together the SMSS and in the survey it was referred to as the ADMIRE (Assessment of a Disease management system with Medical devices In REnal disease) system.
Measures
A tailored renal transplant patient technology acceptance questionnaire was developed for this study. This questionnaire included several items to measure each construct included in the renal transplant patient technology acceptance model. Initial questionnaire items were based on the questionnaires reported in the literature [12, 13, 31-33, 36-38, 45-48]. These initial items were discussed in workshops with a doctor, experienced patients, and researchers in the self-management domain. This resulted in an adjusted set of items that was adapted to 1) the content of the SMSS and 2) patients’ language and knowledge. The items were all statements that had to be rated on a 7-point Likert scale with 1 for totally disagree to 7 for totally agree with the statement and a ‘not applicable’ option. Participants were asked to complete the questionnaire at the start of the study (T0) and after four months of using the SMSS (T1). In most cases, at T0, the questionnaire items formulation prompted for future use, while at T1 the items formulation prompted for current use. For example, the performance expectancy item PE1 at T0 was formulated as “with the ADMIRE system, I will be able to monitor my health very well myself”, while at T1 it was formulated as “with the ADMIRE system, I can monitor my health very well myself”. Still, both in T0 and T1 items related to the behavioural intention always prompted for future usage. The items were in Dutch. An English translation of the T1 questionnaire items can be found in Additional file 1. At T0, patients’ demographic data was collected, including the knowledge dimension items of the Partners in Health (PIH) scale that assesses patients’ perceived chronic condition self-management knowledge [49]. The PIH items were rated on a 9-
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