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

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.