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

AimsThis 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.DesignCross-sectional study.MethodsThis 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.ResultsThe final model showed good fit (chi 2/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.ConclusionThe 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 MethodStrengthening the Reporting of Observational Studies in Epidemiology (STROBE).Patient or Public ContributionIn public or patient involvement in this study.