134 Selection of strategies With desk-research, we selected fourteen example strategies suiting the objectives and determinants. Examples are a video animation, leaflet, group meeting, website texts, a card to prepare consultations, recipes, strategies of goal setting, the use of reminders and peer support. During the interviews, visual strategies, such as an animation explaining CKD and symbols indicating important CKD symptoms to discuss, received the most positive feedback. Patients stated these helped to make them aware, knowledgeable and to make better decisions. Additionally, patients mentioned improved communication with HCPs should be part of an intervention, because it offers the chance to ask questions and to discuss the personal situation, which is important to be able to change and maintain self-management at home. Patients shared their enthusiasm about a card to prepare consultations and to take home advices of the HCP. Written or Internet based strategies, or group meetings were not preferred often. Patients mentioned to lack reading or digital competences, or to lack digital devices. Group meetings were not preferred, because patients did not want to visit their health care organizations more often, or the presence of peers would complicate to speak out. The quotes below illustrate the feedback during the interviews: Patient with moderate CKD, male, 67 years: ‘I need videos or pictures to understand. I do not read often. If I do, the information will not stick. The video I just saw made things clear’. Patient with moderate CKD, male, 81 years, about the card to support consultations: ‘This card can help, because I am older. I sometimes don’t know what to say and I have problems remembering everything’. Patient with severe CKD, male, 75 years: ‘Group education is not for me. I would feel uncomfortable, and not contribute much. I prefer to do it by myself or with the help of my wife’.
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