The present study was designed to address gaps in the existing literature and advance the scientific understanding of adherence among pediatric renal and liver transplant recipients by assessing how various psychosocial variables are related to adherence and subsequent health outcomes. Specifically, this study examined the influence of hope, illness-related uncertainty, anxiety, and depression on adherence. 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 an electronic monitoring system. A partial least squares estimation procedure was used to examine the hypothesized relationships, between constructs depicted in the theoretical model. The results indicated that individuals with high levels of hope and low levels of illness-related uncertainty are likely to adhere to their medication regimen only to the extent that they are not experiencing symptoms of depression. Additionally, the results also suggest that non-clinical levels of anxiety are associated with better rates of adherence. The findings of this study suggest mechanisms for identifying patients that may be at risk for nonadherence as well as for developing an intervention program that focuses on improving adherence rates among pediatric renal and liver transplant recipients. Research and clinical implications are discussed in light of the findings of this study.
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