The relationship of hope and illness-related uncertainty to emotional adjustment and adherence among pediatric renal and liver transplant recipients

Julie M. Maikranz; Ric G. Steele; Meredith L. Dreyer; Aaron C. Stratman; James A. Bovaird

doi:10.1093/jpepsy/jsl046

The relationship of hope and illness-related uncertainty to emotional adjustment and adherence among pediatric renal and liver transplant recipients

Julie M. Maikranz, Ric G. Steele, Meredith L. Dreyer, Aaron C. Stratman, James A. Bovaird

Educational Psychology

Research output: Contribution to journal › Article › peer-review

68 Scopus citations

Abstract

Objective: To examine, using partial least squares (PLS) modeling, the associations among hope, illness-related uncertainty, anxiety, depression, and adherence in a sample of children with renal and liver transplantations. Methods: Seventy pediatric renal and liver transplant recipients and their caregivers participated in a 3-month study which involved completing questionnaires and monitoring adherence via self-report and electronic monitoring (MEMS™ caps). A PLS estimation procedure was used to examine the associations among constructs in the theoretical model. Results: Hope and uncertainty were associated with both depressive symptoms and anxiety, and depressive symptoms were associated with treatment adherence. The association of hope and adherence to treatment was fully mediated by depressive symptoms. Conclusions: Findings suggest mechanisms for identifying patients that may be at risk for nonadherence and components for intervention programs to improve adherence rates among pediatric transplant recipients.

Original language	English (US)
Pages (from-to)	571-581
Number of pages	11
Journal	Journal of pediatric psychology
Volume	32
Issue number	5
DOIs	https://doi.org/10.1093/jpepsy/jsl046
State	Published - Jun 2007

Keywords

Adherence
Anxiety
Depressive symptoms
Hope
Pediatric transplantation
Uncertainty

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology

Access to Document

10.1093/jpepsy/jsl046

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The relationship of hope and illness-related uncertainty to emotional adjustment and adherence among pediatric renal and liver transplant recipients. / Maikranz, Julie M.; Steele, Ric G.; Dreyer, Meredith L.; Stratman, Aaron C.; Bovaird, James A.

In: Journal of pediatric psychology, Vol. 32, No. 5, 06.2007, p. 571-581.

Research output: Contribution to journal › Article › peer-review

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title = "The relationship of hope and illness-related uncertainty to emotional adjustment and adherence among pediatric renal and liver transplant recipients",

abstract = "Objective: To examine, using partial least squares (PLS) modeling, the associations among hope, illness-related uncertainty, anxiety, depression, and adherence in a sample of children with renal and liver transplantations. Methods: Seventy pediatric renal and liver transplant recipients and their caregivers participated in a 3-month study which involved completing questionnaires and monitoring adherence via self-report and electronic monitoring (MEMS{\texttrademark} caps). A PLS estimation procedure was used to examine the associations among constructs in the theoretical model. Results: Hope and uncertainty were associated with both depressive symptoms and anxiety, and depressive symptoms were associated with treatment adherence. The association of hope and adherence to treatment was fully mediated by depressive symptoms. Conclusions: Findings suggest mechanisms for identifying patients that may be at risk for nonadherence and components for intervention programs to improve adherence rates among pediatric transplant recipients.",

keywords = "Adherence, Anxiety, Depressive symptoms, Hope, Pediatric transplantation, Uncertainty",

author = "Maikranz, {Julie M.} and Steele, {Ric G.} and Dreyer, {Meredith L.} and Stratman, {Aaron C.} and Bovaird, {James A.}",

note = "Funding Information: This investigation was supported by University of Kansas General Research Fund allocation #2301132 awarded to Ric G. Steele, PhD. Data analysis was supported by a research grant from the NICHD (Mental Retardation Research Center Grant-HD02528). We thank the liver transplant staff at Children{\textquoteright}s Mercy Hospital, Cardinal Glennon Children{\textquoteright}s Hospital, St Louis Children{\textquoteright}s Hospital, Cincinnati Children{\textquoteright}s Hospital Medical Center, and Baptist Medical Center of Oklahoma. We are also grateful to the renal transplant staff at Cincinnati Children{\textquoteright}s Hospital Medical Center and St Louis Children{\textquoteright}s Hospital. Finally, the authors wish to thank the participants and their families who helped us better understand how to improve adherence and the health of transplant patients in the future. Conflict of interest: None declared.",

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AU - Stratman, Aaron C.

AU - Bovaird, James A.

N1 - Funding Information: This investigation was supported by University of Kansas General Research Fund allocation #2301132 awarded to Ric G. Steele, PhD. Data analysis was supported by a research grant from the NICHD (Mental Retardation Research Center Grant-HD02528). We thank the liver transplant staff at Children’s Mercy Hospital, Cardinal Glennon Children’s Hospital, St Louis Children’s Hospital, Cincinnati Children’s Hospital Medical Center, and Baptist Medical Center of Oklahoma. We are also grateful to the renal transplant staff at Cincinnati Children’s Hospital Medical Center and St Louis Children’s Hospital. Finally, the authors wish to thank the participants and their families who helped us better understand how to improve adherence and the health of transplant patients in the future. Conflict of interest: None declared.

PY - 2007/6

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N2 - Objective: To examine, using partial least squares (PLS) modeling, the associations among hope, illness-related uncertainty, anxiety, depression, and adherence in a sample of children with renal and liver transplantations. Methods: Seventy pediatric renal and liver transplant recipients and their caregivers participated in a 3-month study which involved completing questionnaires and monitoring adherence via self-report and electronic monitoring (MEMS™ caps). A PLS estimation procedure was used to examine the associations among constructs in the theoretical model. Results: Hope and uncertainty were associated with both depressive symptoms and anxiety, and depressive symptoms were associated with treatment adherence. The association of hope and adherence to treatment was fully mediated by depressive symptoms. Conclusions: Findings suggest mechanisms for identifying patients that may be at risk for nonadherence and components for intervention programs to improve adherence rates among pediatric transplant recipients.

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