**5. Conclusion**

Throughout our analysis, we have highlighted the type of education programmes developed to teach kidney transplant patient and how these programmes are delivered in terms of structure, content, and outcomes.

After kidney transplantation, patients are heading towards a new path that requires them to adapt to the changes in their lives [55]. The continuity of the functioning of the new organ is ensured through the adherence to immunosuppressive medication, early detection of signs and symptoms of complications, organ rejection, infections, adverse effects of medication and other conditions present in their daily lives [48].

The literature shows that about 36–55% of transplant recipients do not comply with what may be the cause of organ dysfunction and risk of rejection [56].

The lack of knowledge, skills, support for self-care activities and demotivation represent contexts that are not conducive to learning and participation, thus raising the need for interventional spaces in the organisational fabric of health [56].

As highlighted by Bertram and colleagues, how can one deal with the disease if one does not know how to do it? [57].

The dialectic between patients/caregivers and health professionals is conditioned by the information/knowledge needs of the patient and the holistic view of professionals towards the former. In this context, the value of participation is visible, firstly in the identification of needs and, secondly, in the development of educational programs focused on the patient and the identified needs [27].

Due to the characteristics already mentioned in this study, nursing professionals represent a privileged group in the field of patient education. By designing and managing education programs, they teach patients in a space of negotiation between different actors (patients and caregivers), identify needs, and interact with everyone in the search for solutions and strategies to restore patients' autonomy and empowerment to properly manage their disease [54].

Education programmes are situated in a collaborative modality between the health system and the patients and their family and social system. It requires a bilateral and interactive collaboration. They are designed according to the organisational model

of care and can be based on a more traditional model or a more innovative model, such as the patient-centred model. The combination of sometimes differentiated but negotiable interests is important as a privileged form of relationship between the health system and the patient.

Our analysis has shown that education programmes vary between different countries and even within each country they often vary between institutions and within the same institution. Hence the importance of programmes being structured and trained by the professionals delivering them to avoid negative consequences for learners, such as confusion and loss of confidence [30].

Our final message refers to the fact that educating, teaching and instructing are three fundamental and crucial concepts for patient autonomy and empowerment, especially for chronic patients, such as kidney transplant patients.

Underlying this statement is education with the patient rather than for the patient. This is the most effective way to achieve the transfer of knowledge and skills essential for the patient to properly care for him/herself. It is important to remember that nursing professionals assume only the role of facilitators and mediators in the educational process and that the rest of the process belongs to the patient.
