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Background: Self-management support systems (SMSS) have been proposed for renal transplant patients to increase their autonomy and reduce the number of hospital visits. For the design and implementation of such systems, it is important to understand factors influencing patients' acceptance of a SMSS. This paper aims to identify these key factors.Methods: From literature, possible factors and related questionnaire items were identified. Afterwards, focus groups with experts and patients were conducted to adapt the items to the application domain. To investigate acceptance of a SMSS and the influencing factors, fifty renal transplant patients answered the questionnaire before and after using the SMSS for 4 months.Results: All the questionnaire constructs had a satisfactory or higher level of reliability. After using the SMSS for 4 months, trust and performance expectancy could explain part of the variation in behavioural intention of using the SMSS, but not beyond the explanation given by patients' affect towards the system, which accounted for 26% of the variance.Conclusions: We anticipate that in future caregivers implementing a SMSS will benefit from taking steps to improve patients' affect as this was found to correlate with patients use intention.Trial Registration: The study was registered in ToetsingOnline, a registry held by the Dutch Central Committee on Research Involving Human Subjects. The registration number is NL33387.058.11 , and the date of registration is 31st July 2012. [ABSTRACT FROM AUTHOR]

Background: After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients' experiences and satisfaction. Materials and methods: For 3 months after transplantation, 30 patients registered selfmeasured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements. Results: Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P,0.01), level of self-efficacy (P,0.01), and amount of trust in the accuracy of the creatinine meter (P,0.01). The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the accuracy of the creatinine device being relatively low. Trust in the accuracy of the creatinine device appeared to be related to level of variation in subsequent measurement results, with more variation being related to lower levels of trust. Protocol adherence was generally very high, although the range of adherence levels was large and increased over time. Conclusion: Patients' high levels of satisfaction suggest that at-home monitoring of creatinine and blood pressure after transplantation offers a promising strategy. Important prerequisites for safe implementation in transplant care seem to be support from physicians and patients' confidence in both their own self-monitoring skills and the accuracy of the devices used. [ABSTRACT FROM AUTHOR]