{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:04:10Z","timestamp":1789358650729,"version":"build-2803163510"},"reference-count":47,"publisher":"Springer Publishing Company","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Res Theory Nurs Pract"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background and Purpose:<\/jats:bold>\n                    Given the unique therapeutic challenges that kidney transplant recipients with posttransplantation diabetes mellitus face, understanding how self-care confidence influences self-care maintenance is paramount. This study aimed to examine the mediating role of self-care confidence in the association between health literacy and self-care maintenance among kidney transplant recipients with posttransplantation diabetes mellitus.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This study used a cross-sectional, descriptive, and correlational design. A convenience sample of 109 participants was recruited from a single tertiary hospital, and participants completed a web-based questionnaire. The mediation analysis was conducted using the percentile bootstrap method, controlling for participants\u2019 general characteristics.\n                    <jats:bold>Results:<\/jats:bold>\n                    Health literacy was significantly associated with self-care maintenance (\u03b2 = 0.55,\n                    <jats:italic>B<\/jats:italic>\n                    = 1.03,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; .001, 95% confidence interval [CI] [0.66, 1.41]). Including self-care confidence reduced the direct effect (\u03b2 = 0.37,\n                    <jats:italic>B<\/jats:italic>\n                    = 0.69 ,\n                    <jats:italic>p<\/jats:italic>\n                    = .001, 95% CI [0.31, 1.08]), indicating partial mediation. The completely standardized indirect effect was significant (\u03b2 = 0.18, 95% CI [0.07, 0.32]), and the model explained 45% of the variance in self-care maintenance (\n                    <jats:italic>R\u00b2<\/jats:italic>\n                    = .45).\n                    <jats:bold>Implications for Practice:<\/jats:bold>\n                    Strengthening self-care confidence may enhance self-care maintenance, while ongoing strategies to support health literacy remain important.\n                  <\/jats:p>","DOI":"10.1891\/rtnp-2025-0120","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T09:55:19Z","timestamp":1783763719000},"page":"386-404","source":"Crossref","is-referenced-by-count":0,"title":["Health Literacy and Self-Care Maintenance in Posttransplantation Diabetes Mellitus Among Kidney Transplant Recipients: The Mediating Role of Self-Care Confidence"],"prefix":"10.1891","volume":"40","author":[{"given":"Seo Ha","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Sook","family":"Roh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"793","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"issue":"4","key":"2026090322001062000_40.3.386.1","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s13300-020-00790-5","article-title":"Post-transplantation diabetes mellitus","volume":"11","year":"2020","journal-title":"Diabetes Therapy"},{"issue":"7","key":"2026090322001062000_40.3.386.2","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13071928","article-title":"New-onset diabetes mellitus after kidney transplantation","volume":"13","year":"2024","journal-title":"Journal of Clinical Medicine"},{"key":"2026090322001062000_40.3.386.3","doi-asserted-by":"publisher","DOI":"10.2337\/DC25-S002"},{"issue":"1","key":"2026090322001062000_40.3.386.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12902-017-0218-y","article-title":"Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: The Self-Care of Diabetes Inventory","volume":"17","year":"2017","journal-title":"BMC Endocrine Disorders"},{"issue":"3","key":"2026090322001062000_40.3.386.5","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12030977","article-title":"A cross-sectional analysis of health literacy and compliance to treatment in organ transplant recipients","volume":"12","year":"2023","journal-title":"Journal of Clinical Medicine"},{"issue":"5","key":"2026090322001062000_40.3.386.6","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s40620-022-01537-0","article-title":"Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: A systematic review","volume":"36","year":"2023","journal-title":"Journal of Nephrology"},{"key":"2026090322001062000_40.3.386.7","doi-asserted-by":"crossref","DOI":"10.2196\/50898","article-title":"Roles of health literacy in relation to social determinants of health and recommendations for informatics-based interventions: Systematic review","volume":"16","year":"2024","journal-title":"Online Journal of Public Health Informatics"},{"issue":"12","key":"2026090322001062000_40.3.386.8","doi-asserted-by":"crossref","first-page":"52","DOI":"10.5430\/jnep.v11n12p52","article-title":"Self-care of liver, kidney and bone marrow transplant patients with diabetes","volume":"11","year":"2021","journal-title":"Journal of Nursing Education and Practice"},{"key":"2026090322001062000_40.3.386.9","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.2147\/PPA.S183092","article-title":"Health literacy in solid-organ transplantation: A model to improve understanding","volume":"12","year":"2018","journal-title":"Patient Preference and Adherence"},{"issue":"6","key":"2026090322001062000_40.3.386.10","doi-asserted-by":"crossref","DOI":"10.1111\/dme.14523","article-title":"Association of British Clinical Diabetologists and Renal Association guidelines on the detection and management of diabetes post solid organ transplantation","volume":"38","year":"2021","journal-title":"Diabetic Medicine"},{"issue":"1","key":"2026090322001062000_40.3.386.11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.anr.2017.02.001","article-title":"A new comprehensive short-form health literacy survey tool for patients in general","volume":"11","year":"2017","journal-title":"Asian Nursing Research"},{"issue":"3","key":"2026090322001062000_40.3.386.12","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1007\/s12020-020-02354-w","article-title":"How do self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in adults with type 2 diabetes? 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F . (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3 rd ed.). 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