Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience
IntroductionIn China’s collectivist healthcare context, the mechanisms linking social support to quality of life (QoL) in heart transplant recipients remain unclear. This study integrates Mishel’s uncertainty in illness theory and Confucian resilience frameworks to cross-sectionally examine dual pat...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1637110/full |
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| author | Chan Gao Chan Gao Song Gui Song Gui Lijun Zhu Lijun Zhu Xiaoqian Bian Heyong Shen Can Jiao Can Jiao |
| author_facet | Chan Gao Chan Gao Song Gui Song Gui Lijun Zhu Lijun Zhu Xiaoqian Bian Heyong Shen Can Jiao Can Jiao |
| author_sort | Chan Gao |
| collection | DOAJ |
| description | IntroductionIn China’s collectivist healthcare context, the mechanisms linking social support to quality of life (QoL) in heart transplant recipients remain unclear. This study integrates Mishel’s uncertainty in illness theory and Confucian resilience frameworks to cross-sectionally examine dual pathways: direct enhancement of QoL through social support and indirect reduction of uncertainty in illness, moderated by culturally embedded psychological resilience.MethodsA nationwide cross-sectional study included 428 Chinese heart transplant recipients. Social support (SSRS), uncertainty in illness (MUIS-A), resilience (CD-RISC), and QoL (SF-36) were assessed. Mediation (PROCESS Model 4) and moderated mediation (Model 14) were tested using 5,000 bootstrap resamples, controlling for age, gender, and transplant duration.ResultsSocial support directly improved QoL (B = 0.625, p < 0.001, direct effect = 0.435, 95% CI [0.285, 0.584]) and indirectly reduced uncertainty in illness (indirect effect = 0.19, 95% CI [0.126, 0.265]). Psychological resilience moderated the uncertainty in illness-QoL link (B = 0.007, p < 0.001), with stronger negative effects in low-resilience individuals (B = -0.372 vs. high-resilience B = -0.111).ConclusionBased on this cross-sectional study, social support demonstrates significant associations with dual pathways: directly associated with improved QoL through relational support networks and indirectly linked to reduced uncertainty in illness via culturally mediated cognitive reframing. Culturally interventions integrating family-centered care and resilience training are recommended to improve long-term outcomes. |
| format | Article |
| id | doaj-art-4c90fba8e12b40da92c95aeed8dea490 |
| institution | DOAJ |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-4c90fba8e12b40da92c95aeed8dea4902025-08-20T03:03:12ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.16371101637110Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilienceChan Gao0Chan Gao1Song Gui2Song Gui3Lijun Zhu4Lijun Zhu5Xiaoqian Bian6Heyong Shen7Can Jiao8Can Jiao9School of Psychology, Shenzhen University, Shenzhen, ChinaThe Shenzhen Humanities & Social Sciences Key Research Bases, Center for Mental Health, Shenzhen University, Shenzhen, ChinaSchool of Psychology, Shenzhen University, Shenzhen, ChinaThe Shenzhen Humanities & Social Sciences Key Research Bases, Center for Mental Health, Shenzhen University, Shenzhen, ChinaSchool of Psychology, Shenzhen University, Shenzhen, ChinaThe Shenzhen Humanities & Social Sciences Key Research Bases, Center for Mental Health, Shenzhen University, Shenzhen, ChinaInstitute of Analytical Psychology, City university of Macau, Macau, ChinaInstitute of Analytical Psychology, City university of Macau, Macau, ChinaSchool of Psychology, Shenzhen University, Shenzhen, ChinaThe Shenzhen Humanities & Social Sciences Key Research Bases, Center for Mental Health, Shenzhen University, Shenzhen, ChinaIntroductionIn China’s collectivist healthcare context, the mechanisms linking social support to quality of life (QoL) in heart transplant recipients remain unclear. This study integrates Mishel’s uncertainty in illness theory and Confucian resilience frameworks to cross-sectionally examine dual pathways: direct enhancement of QoL through social support and indirect reduction of uncertainty in illness, moderated by culturally embedded psychological resilience.MethodsA nationwide cross-sectional study included 428 Chinese heart transplant recipients. Social support (SSRS), uncertainty in illness (MUIS-A), resilience (CD-RISC), and QoL (SF-36) were assessed. Mediation (PROCESS Model 4) and moderated mediation (Model 14) were tested using 5,000 bootstrap resamples, controlling for age, gender, and transplant duration.ResultsSocial support directly improved QoL (B = 0.625, p < 0.001, direct effect = 0.435, 95% CI [0.285, 0.584]) and indirectly reduced uncertainty in illness (indirect effect = 0.19, 95% CI [0.126, 0.265]). Psychological resilience moderated the uncertainty in illness-QoL link (B = 0.007, p < 0.001), with stronger negative effects in low-resilience individuals (B = -0.372 vs. high-resilience B = -0.111).ConclusionBased on this cross-sectional study, social support demonstrates significant associations with dual pathways: directly associated with improved QoL through relational support networks and indirectly linked to reduced uncertainty in illness via culturally mediated cognitive reframing. Culturally interventions integrating family-centered care and resilience training are recommended to improve long-term outcomes.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1637110/fullheart transplantationsocial supportuncertainty in illnesspsychological resiliencequality of lifemoderated mediation model |
| spellingShingle | Chan Gao Chan Gao Song Gui Song Gui Lijun Zhu Lijun Zhu Xiaoqian Bian Heyong Shen Can Jiao Can Jiao Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience Frontiers in Psychiatry heart transplantation social support uncertainty in illness psychological resilience quality of life moderated mediation model |
| title | Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience |
| title_full | Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience |
| title_fullStr | Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience |
| title_full_unstemmed | Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience |
| title_short | Social support and quality of life in Chinese heart transplant recipients: mediation through uncertainty in illness and moderation by psychological resilience |
| title_sort | social support and quality of life in chinese heart transplant recipients mediation through uncertainty in illness and moderation by psychological resilience |
| topic | heart transplantation social support uncertainty in illness psychological resilience quality of life moderated mediation model |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1637110/full |
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