152 Patients have the practical competences to improve lifestyle and medication HCPs translate general self-management advices into action points HCPs respond to problems of the patient with advices to improve them ‘Advises on lifestyle and medication are too generic. I miss how to practice them at home’ ‘The HCP is helping me to solve my practical problems with lifestyle or medication intake’ Patients recognize and solve barriers that negatively influence their self-management (such as negative emotions, feasibility problems) Patients know strategies to prevent relapse of selfmanagement changes Patients share their barriers, concerns and relapse with HCPs. HCPs seek for solutions for barriers, by applying shared decision making ‘I often start to improve my lifestyle, but it is difficult to maintain’ ‘If needed, I will find solutions if things are going wrong’ ‘I do not always share my problems regarding lifestyle and medication with the HCP’ Patients involve the social network in the consultation and treatment Patients seek additional help in the social network if they experience barriers HCPs involve the social network in the consultation and treatment HCPs empower the social network to contribute to selfmanagement ‘A significant other is responsible for my diet or medication’ ‘If I experience mental or physical problems or feel uncertain, I seek additional help’ ‘My HCP involves my significant others, for example in consultations’ # We selected a feasible amount of quotations to prevent that we asked too much of the patient. Therefore the number of quotations differs from the objectives. CKD = chronic kidney disease, HCP = health care professional. Supplementary file 2. continued Participant ID CPD1 Experiences related to determinants under awareness and knowledge Has been a kidney patient for years and has gradually learned quite a bit. Knows how to explain what the kidneys are and because of multiple transplants and years of dialysis, he is well aware of the risks. When he reads from the screen, I notice a lot of difficulty with written language. Something that is also confirmed by the questionnaire. Knows what is expected of him in lifestyle and can also name products that contain bad nutrients. Also good in understanding lab results. Preference for intervention strategies related to improving awareness and knowledge Finds it difficult to determine the type of intervention. On the one hand, his sister helps him with many things and it would be good for her to get information about illness and treatment together. On the other hand, he also finds autonomy important and sometimes wants to go to the cafe after a conversation. Alone or in pairs. Feels less for a group. He only shares problems with friends or family. Is enthusiastic abou the video and listens attentively. After watching, he indicates that a lot is correct in the video and it is a good way of informing in his eyes. Recognition of determinants related to communication with HCPs about the kidneys, risks and self-management preparation Does not recognize the communication problems very strongly. Thinks that he discusses many of his complaints with the doctor and also knows what is important. His example, neck pain, which he just talked about extensively with the nurse practioner, is not really a symptom of kidney problems, and brings up the question if he really knows important symptoms. Indicates that the doctor determines what is important to do in self-management and that you should not contradict it, because the doctor knows best. Doesn't always benefit from the advice about lifestyle, because he can't manage it that way. Would also like his network to be included in what needs to be done, because things often go differently or wrong when he tries. Supplementary file 3. Example of the form to collect experiences regarding the determinants from the interviews
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