Effect of Roy Adaptation Model-Based Patient Education on Self-Efficacy, Immunosuppressive Therapy Adherence, and Adaptation to Chronic Disease in Patients With Kidney Disease

Abstract

BACKGROUND: Chronic kidney disease (CKD) is a global health challenge requiring strict medication adherence to prevent complications. The Roy Adaptation Model (RAM) provides a nursing framework to guide patients toward holistic adaptation during this process. OBJECTIVE: We aimed to examine the effect of RAM-based patient education on self-efficacy, immunosuppressive adherence, and adaptation to chronic disease in patients receiving immunosuppressive therapy. METHODS: The quasi-experimental study included 78 patients (39 intervention and 39 control) comprising new renal transplant recipients and patients with CKD initiating immunosuppressive therapy for the first time at a university hospital. The intervention group received individualized education based on the RAM's 4 adaptation modes, supported by an educational booklet, while the control group received routine care. Data were collected at baseline, 1, and 3 months. Self-efficacy, medication adherence, and adaptation to chronic disease were measured using validated instruments. RESULTS: < .05). Medication adherence in the intervention group improved over time. Significant effect sizes were observed in all sub-dimensions of disease adaptation and self-efficacy. CONCLUSIONS: Educational interventions grounded in the RAM appear to support treatment adherence, self-efficacy, and adaptation in kidney patients. Integrating the RAM into nursing practice may offer a structured framework for patient-centered care, may assist in chronic disease management, and may support patients' active engagement in care. CLINICALTRIALS: gov Registration:NCT07430449.

The authors' abstract, as published at the source. Western Journal of Nursing Research, 2026 · DOI ↗