135 Step 4: Program production The divergent experiences of patients from different settings (table 4.2), led to the decision to target the intervention towards ambulatory setting. Based on step 2 and 3, we developed: 1. Component one and two for patients: a website and brochure with many visual strategies, such as animations and photo stories. These consisted of two parts. Part one was intended to meet our aim of improving awareness and understanding of CKD and the importance of lifestyle and medication. Part two aimed to explain lifestyle and medication, and to gain competence in communicating with HCPs effectively. 2. Component three: a card to improve consultations. This card helps patients to prepare and discuss self-management actions, needs and barriers, and HCPs to summarize information and actions for self-management. This card enables the patient to develop practical competences and helps to maintain self-management changes. For these strategies we, again, collected feedback. The advisory board of patients, HCPs and researchers stated the intervention needed further improvement to support practical competences and maintaining longterm behavior changes. Additionally, they suggested delivering an additional intervention component after the consultation, so that patients could follow-up on the advice of the HCP. Therefore, seven topic-based brochures were added to the strategies. These aimed to provide practical guidance, stimulate help seeking and prevent relapse. Based on the feedback, we completed the intervention with information that helped to improve competences. Examples are the addition of 1) a video/cartoon that helped to recognize unhealthy foods, and 2) cartoons showing how patients can make consultations more effective[43]. Further, text was simplified and shortened, and re-organized. Discussion of the card led to adding or combining of icons, for example on emotions and living with kidney disease.
RkJQdWJsaXNoZXIy MTk4NDMw