Xia Huang

Objective: Psychosocial adjustment is an important component of recovery after liver transplantation, particularly among young and middle-aged recipients during the early postoperative period. Although illness perception has been associated with psychosocial adjustment, the statistical pathways underlying this association in this population remain unclear. This study aimed to examine the association between illness perception and psychosocial adjustment and to determine whether perceived social support and quality of life statistically mediated this association. Methods: A questionnaire survey was conducted among 216 young and middle-aged liver transplant recipients. The instruments included the Brief Illness Perception Questionnaire (B-IPQ), Perceived Social Support Scale (PSSS), Post-Liver Transplant Quality of Life Questionnaire, and Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR). Structural equation modeling was used to evaluate the proposed statistical serial mediation model, and the Bootstrap method was adopted to examine the significance of statistical indirect effects. Results: Illness perception was positively associated with psychosocial adjustment problems ( β = 0.240, p = 0.002). Bootstrap analysis showed significant statistical indirect associations through perceived social support, quality of life, and the sequential pathway of perceived social support and quality of life. The total indirect association accounted for 43.26% of the total association. Conclusion: Illness perception was associated with poorer psychosocial adjustment among young and middle-aged liver transplant recipients during the early postoperative period, with perceived social support and quality of life serving as statistical mediators. These findings suggest that early postoperative interventions may need to integrate illness-cognition regulation, supportive resource enhancement, and quality-of-life improvement to support psychosocial adjustment.

Based on the “Three-Dimensional Quality Structure” theory, a sensitive index system of nursing quality during the perioperative period of liver transplantation patients was constructed. Through a comprehensive literature review and rigorous application of the Delphi method, a panel of 27 experts completed three rounds of effective letter consultation to obtain expert consensus opinions. The contents of indicators were determined based on this process, and the analytic hierarchy process was employed to confirm the weightage assigned to each indicator. Consequently, we established a sensitive index system of nursing quality during the perioperative period of liver transplantation patients. The effective recovery rates of the questionnaires in the three rounds of expert consultation reached 96.6%, 100% and 96.4%, respectively, and the proportions of experts who gave opinions were 55%, 25% and 12%,respectively, indicating a high degree of expert authority. The expert authority coefficients were calculated to be 0.899, 0.895 and 0.909,respectively, indicating a high degree of expert authority. In the third round, Kendall’s coordination coefficients for primary, secondary, and tertiary indicators were determined to be 0.340, 0.379, and 0.402 (P < 0.001), indicating that expert opinions tended to be consistent. Finally, We established a comprehensive sensitivity quality index system comprising 3 first-level indexes,11 s-level indexes, and 60 third-level indexes specifically designed for liver transplantation patients during the perioperative period. The sensitive index system of perioperative nursing quality for liver transplantation patients can provide a theoretical basis for nursing staff to construct precise individualized nursing models.

Purpose Financial toxicity has become a global public health issue. The purpose of the study is to investigate and analyze the influencing factors of financial toxicity in patients with non-metastatic colorectal cancer. Methods A convenient sample of 250 patients with stage I-III colorectal cancer was investigated in the study. They completed a set of questionnaires, including the Comprehensive Score for Financial Toxicity questionnaire, the Perceived Social Support Scale, and the Hospital Anxiety and Depression Scale. Univariate and multivariate linear regression were performed to investigate the influencing factors of financial toxicity. Results Over half (52.8%, n = 132) of the colorectal cancer survivors experienced financial toxicity. Multivariate regression analysis showed that the factors associated with financial toxicity were young age, unemployment, low annual household income, chemotherapy, and the lack of sufficient social support (p < 0.05). Conclusions Financial toxicity is common among non-metastatic colorectal cancer survivors. Young age, lower annual household income, unemployment, chemotherapy, and insufficient social support were associated with financial toxicity.