Resilience and its mediating role in the association between family functioning and symptom experience in kidney transplant recipients: A cross-sectional study
4 affiliations
- 1Hemodialysis Center, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, Hubei, China
- 2The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- 3The Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- 4Nursing Department, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
Abstract
Objective: To investigate the levels of family functioning, resilience, and symptom experience in kidney transplant recipients, and to examine the mediating role of resilience in the relationship between family functioning and symptom experience. Methods: A cross-sectional study was conducted from January to February 2025. A convenience sample of 333 kidney transplant recipients was recruited from a tertiary hospital in Wuhan, China. Participants completed the Chinese Version of the Resilience Scale for Kidney Transplantation, the Organ Transplant Symptom and Well-being Inventory, and the Family APGAR Index. Data were analyzed using correlation, hierarchical regression, and bootstrap mediation tests. Results: Participants reported a moderate level of symptom burden (OTSWI total score: 46.56 ± 23.86). Both resilience (r = –0.222, p < .01) and family functioning (r = –0.202, p < .01) were significantly correlated with lower symptom burden. After controlling for demographic and clinical variables, resilience (β = −0.152, p = .005) and family functioning (β = −0.124, p = .022) remained independent predictors. Mediation analysis showed that resilience was consistent with a partial mediating role in the relationship between family functioning and symptom experience, accounting for 18.4% of the total effect (indirect effect = –0.326, 95% BCa CI [–0.645, –0.081]). Conclusion: The findings are consistent with resilience partially mediating the association between family functioning and symptom experience in kidney transplant recipients. Assessing both family support and psychological resilience may help identify high-risk patients and inform integrated interventions aimed at alleviating symptom burden.Given the cross-sectional design, causal inference cannot be established.
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BibTeX
@article{tang2026resilience,
title = {{Resilience and its mediating role in the association between family functioning and symptom experience in kidney transplant recipients: A cross-sectional study}},
author = {Yan Tang and Jiefu Zhu and Jinke Li and Jiangqiao Zhou and Rong Wang and Tao Qiu},
journal = {PLOS One},
year = {2026},
month = nov,
doi = {10.1371/journal.pone.0361968},
url = {https://doi.org/10.1371/journal.pone.0361968},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Resilience and its mediating role in the association between family functioning and symptom experience in kidney transplant recipients: A cross-sectional study
AU - Yan Tang
AU - Jiefu Zhu
AU - Jinke Li
AU - Jiangqiao Zhou
AU - Rong Wang
AU - Tao Qiu
PY - 2026
DA - 2026/11/12
JO - PLOS One
DO - 10.1371/journal.pone.0361968
UR - https://doi.org/10.1371/journal.pone.0361968
AB - Objective: To investigate the levels of family functioning, resilience, and symptom experience in kidney transplant recipients, and to examine the mediating role of resilience in the relationship between family functioning and symptom experience. Methods: A cross-sectional study was conducted from January to February 2025. A convenience sample of 333 kidney transplant recipients was recruited from a tertiary hospital in Wuhan, China. Participants completed the Chinese Version of the Resilience Scale for Kidney Transplantation, the Organ Transplant Symptom and Well-being Inventory, and the Family APGAR Index. Data were analyzed using correlation, hierarchical regression, and bootstrap mediation tests. Results: Participants reported a moderate level of symptom burden (OTSWI total score: 46.56 ± 23.86). Both resilience (r = –0.222, p < .01) and family functioning (r = –0.202, p < .01) were significantly correlated with lower symptom burden. After controlling for demographic and clinical variables, resilience (β = −0.152, p = .005) and family functioning (β = −0.124, p = .022) remained independent predictors. Mediation analysis showed that resilience was consistent with a partial mediating role in the relationship between family functioning and symptom experience, accounting for 18.4% of the total effect (indirect effect = –0.326, 95% BCa CI [–0.645, –0.081]). Conclusion: The findings are consistent with resilience partially mediating the association between family functioning and symptom experience in kidney transplant recipients. Assessing both family support and psychological resilience may help identify high-risk patients and inform integrated interventions aimed at alleviating symptom burden.Given the cross-sectional design, causal inference cannot be established.
SN - 1932-6203
ER -