Associations Between Social Support, Health Literacy and Psychological Resilience to Self-Management Behaviours in Liver Transplant Recipients—A Structural Equation Model

IF 3.5 3区医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2025-03-14 DOI:10.1111/jocn.17697

Yufei Gong, Yinghao Zhou, Dan Zhou, Ao Feng, Bingliang Zhang, Jiamin Wang, Lin Zhao

{"title":"Associations Between Social Support, Health Literacy and Psychological Resilience to Self-Management Behaviours in Liver Transplant Recipients—A Structural Equation Model","authors":"Yufei Gong, Yinghao Zhou, Dan Zhou, Ao Feng, Bingliang Zhang, Jiamin Wang, Lin Zhao","doi":"10.1111/jocn.17697","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>This study aimed to develop a structural model to elucidate the contributions of social support, health literacy and psychological resilience to self-management behaviours in liver transplant recipients after surgery.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Cross-sectional study.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study included 215 Chinese patients who returned to the outpatient department after liver transplantation between June 2023 and March 2024. Data were collected via a general demographic questionnaire, a self-management questionnaire for liver transplant recipients, a chronic disease resource questionnaire, the Connor–Davidson resilience scale and the health literacy scale for chronic patients. Correlation analysis and structural equation modelling were utilised to analyse the relationships among social support, health literacy, psychological resilience and self-management ability.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The final model showed good fit (<i>χ</i><sup>2</sup>/df = 1.690, GFI = 0.919, IFI = 0.951, TLI = 0.938, CFI = 0.950 and RMSEA = 0.057). The direct effect coefficient of social support on self-management ability is 0.293. The indirect effect value of health literacy on the relationship between social support and self-management ability was 0.312, whereas the indirect effect value of psychological resilience in this context was 0.096. Furthermore, the chain-mediating effect involving both health literacy and psychological resilience between social support and self-management ability was 0.109.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The revised model, grounded in social cognitive theory, demonstrated a strong fit for predicting self-management behaviours among liver transplant recipients. Furthermore, social support, health literacy and psychological resilience exerted both direct and indirect influences on the self-management behaviours of these recipients.</p>\n </section>\n \n <section>\n \n <h3> Reporting Method</h3>\n \n <p>Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).</p>\n </section>\n \n <section>\n \n <h3> Patient or Public Contribution</h3>\n \n <p>In public or patient involvement in this study.</p>\n </section>\n </div>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":"34 10","pages":"4366-4376"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jocn.17697","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Aims

This study aimed to develop a structural model to elucidate the contributions of social support, health literacy and psychological resilience to self-management behaviours in liver transplant recipients after surgery.

Design

Cross-sectional study.

Methods

This study included 215 Chinese patients who returned to the outpatient department after liver transplantation between June 2023 and March 2024. Data were collected via a general demographic questionnaire, a self-management questionnaire for liver transplant recipients, a chronic disease resource questionnaire, the Connor–Davidson resilience scale and the health literacy scale for chronic patients. Correlation analysis and structural equation modelling were utilised to analyse the relationships among social support, health literacy, psychological resilience and self-management ability.

Results

The final model showed good fit (χ²/df = 1.690, GFI = 0.919, IFI = 0.951, TLI = 0.938, CFI = 0.950 and RMSEA = 0.057). The direct effect coefficient of social support on self-management ability is 0.293. The indirect effect value of health literacy on the relationship between social support and self-management ability was 0.312, whereas the indirect effect value of psychological resilience in this context was 0.096. Furthermore, the chain-mediating effect involving both health literacy and psychological resilience between social support and self-management ability was 0.109.

Conclusion

The revised model, grounded in social cognitive theory, demonstrated a strong fit for predicting self-management behaviours among liver transplant recipients. Furthermore, social support, health literacy and psychological resilience exerted both direct and indirect influences on the self-management behaviours of these recipients.

Reporting Method

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Patient or Public Contribution

In public or patient involvement in this study.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

肝移植受者社会支持、健康素养与自我管理行为心理弹性的关系——结构方程模型

目的：本研究旨在建立一个结构模型，以阐明社会支持、健康素养和心理弹性对肝移植术后自我管理行为的贡献。设计：横断面研究。方法：本研究纳入了2023年6月至2024年3月期间215例肝移植术后返回门诊的中国患者。通过一般人口统计问卷、肝移植受者自我管理问卷、慢性病资源问卷、Connor-Davidson恢复力量表和慢性患者健康素养量表收集数据。采用相关分析和结构方程模型分析社会支持、健康素养、心理弹性和自我管理能力之间的关系。结果：最终模型拟合良好（χ2/df = 1.690, GFI = 0.919, IFI = 0.951, TLI = 0.938, CFI = 0.950, RMSEA = 0.057）。社会支持对自我管理能力的直接影响系数为0.293。健康素养对社会支持与自我管理能力关系的间接影响值为0.312，心理弹性对社会支持与自我管理能力关系的间接影响值为0.096。此外，健康素养和心理弹性在社会支持与自我管理能力之间的连锁中介效应为0.109。结论：以社会认知理论为基础的修正模型，在预测肝移植受者的自我管理行为方面表现出很强的适应性。此外，社会支持、健康素养和心理弹性对这些接受者的自我管理行为有直接和间接的影响。报告方法：加强流行病学观察性研究报告（STROBE）。患者或公众贡献：公众或患者参与本研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.