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Journal of Pediatric Psychology Advance Access originally published online on December 4, 2006
Journal of Pediatric Psychology 2007 32(5):571-581; doi:10.1093/jpepsy/jsl046
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The Relationship of Hope and Illness-Related Uncertainty to Emotional Adjustment and Adherence Among Pediatric Renal and Liver Transplant Recipients

Julie M. Maikranz, PhD1, Ric G. Steele, PhD, ABPP1, Meredith L. Dreyer, PhD1, Aaron C. Stratman, PhD1 and James A. Bovaird, PhD2

1Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA and 2Department of Educational Psychology, University of Nebraska – Lincoln, Lincoln, NE, USA

All correspondence concerning this article should be addressed to Ric G. Steele, PhD, ABPP, Clinical Child Psychology Program, University of Kansas, 2011 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045-7555, USA. Email: rsteele{at}ku.edu.


  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 (MEMSTM 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.

Key words: adherence; anxiety; depressive symptoms; hope; pediatric transplantation; uncertainty.

Received February 22, 2006; revision received July 10, 2006; revision received October 27, 2006; accepted November 6, 2006


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