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Pathways of psychosocial factors, stress, and health outcomes after liver transplantation


  • Conflict of interest: None.

  • Funded by NIH/NINR: 5 R01 NR009878.

Corresponding author: Carol S. Stilley, University of Pittsburgh School of Nursing, 3500 Victoria Street, Rm 432, Pittsburgh, PA, USA.
Tel.: 412 383 7284; fax: 412 383 7293;


Stilley CS, Flynn WB, Sereika SM, Stimer ED, DiMartini AF, deVera ME. Pathways of psychosocial factors, stress, and health outcomes after liver transplantation.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01467.x.
© 2011 John Wiley & Sons A/S.

Abstract:  The impact of stress and individual factors on health outcomes in general medicine and transplantation are well documented. Few researchers have investigated the complex relationships between these constructs. This longitudinal study assessed coping style, self-regulatory ability, hostility, and social support at baseline among a cohort of 130 adult liver transplant recipients at the Starzl Transplant Institute, University of Pittsburgh Medical Center, and followed those subjects with interview and medical records data about personal and transplant-related stress, physical and mental health outcomes throughout the first post-transplant year. Results show a number of strong bidirectional relationships between coping style, self-regulatory ability, hostility, the caregiver relationship and family environment, personal and transplant-related stress over the second half of the first post-transplant year, and health (especially mental) outcomes at 12 months post-transplant. Stress mediates the relationship between psychosocial factors and mental health outcomes. The importance of those relationships to researchers and clinicians is discussed.