{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:10:32Z","timestamp":1786122632975,"version":"build-2736575974"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postoperative rehabilitation exercise adherence is critical for recovery after pediatric kidney transplantation, yet its associated psychosocial factors remain insufficiently characterized. This study aimed to examine postoperative psychological status and rehabilitation exercise adherence in pediatric kidney transplant recipients, identify distinct adherence patterns, and determine associated influencing factors to inform targeted intervention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal study was conducted among 158 pediatric kidney transplant recipients (101 boys and 57 girls; mean age, 11.91 years; SD, 3.70) who underwent kidney transplantation between May 2008 and May 2024. Data were collected at 1, 2, 4, and 6 months postoperatively using the Rehabilitation Training Adherence Scale, the Pediatric Quality of Life Inventory 4.0 Transplant Module, and the Strengths and Difficulties Questionnaire. Latent class growth modeling and growth mixture modeling were used to identify adherence patterns. Group differences were examined using \u03c7\u00b2 tests and analyses of variance, and associated predictors were identified using multivariate logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three distinct rehabilitation exercise adherence patterns were identified: a high adherence improvement\u2013maintenance pattern (41.8%), a Moderate adherence with early improvement and slight decline pattern (29.7%), and a low adherence\u2013stable pattern (28.5%). These patterns demonstrated substantial heterogeneity in postoperative rehabilitation exercise adherence among pediatric kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Rehabilitation exercise adherence after pediatric kidney transplantation follows distinct longitudinal patterns and is influenced by clinical, demographic, and psychosocial factors. Early identification of recipients at risk of persistently poor adherence may facilitate targeted interventions to improve rehabilitation participation, quality of life, and psychological well-being, thereby promoting better postoperative recovery in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1867348","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:49:01Z","timestamp":1786099741000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with postoperative physiological and psychological changes and rehabilitation exercise adherence in pediatric kidney transplant recipients"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhaoguang","family":"Shang","sequence":"first","affiliation":[{"name":"Department of Physical Education, Zhongyuan University of Technology","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"448","DOI":"10.4103\/1319-2442.284020","article-title":"Changes in body mass index after pediatric renal transplantation","volume":"31","author":"Beladi Mousavi","year":"2020","journal-title":"Saudi J. Kidney Dis. Transpl."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1007\/S00467-011-1887-9","article-title":"Kidney transplantation in childhood: mental health and quality of life of children and caregivers","volume":"26","author":"Diseth","year":"2011","journal-title":"Pediatr. Nephrol."},{"key":"ref3","first-page":"172","article-title":"Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy","volume":"22","author":"Elshafey","year":"2022","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1016\/J.APMR.2016.08.482","article-title":"What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability, and acceptability of measures","volume":"98","author":"Frost","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1569116","DOI":"10.3389\/FNEPH.2025.1569116","article-title":"Medication adherence and outcomes after paediatric kidney transplantation: results from a telemedicine-based, multimodal aftercare approach","volume":"5","author":"Karaterzi","year":"2025","journal-title":"Front Nephrol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1007\/S40746-019-00152-9","article-title":"Chronic kidney disease: treatment of comorbidities I: (nutrition, growth, neurocognitive function, and mineral bone disease)","volume":"5","author":"Kogon","year":"2019","journal-title":"Curr. Treat. Options Pediatr."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1177\/15269248241288563","article-title":"Effect of age at liver transplant on anxiety, depression, and quality of life among adolescents","volume":"34","author":"Marshall","year":"2024","journal-title":"Prog. Transplant."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e70171","DOI":"10.1002\/IJOP.70171","article-title":"From judgement to action: early developmental trajectories of redistribution when facing merit-based inequality","volume":"61","author":"Peng","year":"2026","journal-title":"Int. J. Psychol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1097\/MOT.0000000000001074","article-title":"Postoperative surgical complications after pediatric kidney transplantation in low weight recipients (<15kg): a systematic review","volume":"28","author":"Prudhomme","year":"2023","journal-title":"Curr. Opin. Organ Transplant."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0186644","DOI":"10.1371\/JOURNAL.PONE.0186644","article-title":"Factors associated to acceptable treatment adherence among children with chronic kidney disease in Guatemala","volume":"12","author":"Ramay","year":"2017","journal-title":"PLoS One"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1007\/S00467-015-3074-X","article-title":"The impact of disease duration on quality of life in children with nephrotic syndrome: a Midwest pediatric nephrology consortium study","volume":"30","author":"Selewski","year":"2015","journal-title":"Pediatr. Nephrol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1007\/S00467-023-06236-X","article-title":"Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers","volume":"39","author":"Shingde","year":"2024","journal-title":"Pediatr. Nephrol."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"41","DOI":"10.6002\/ECT.PEDSYMP2024.O6","article-title":"Unveiling the psychosocial impact: pediatric organ transplantation and posttraumatic stress disorders: a systematic review","volume":"22","author":"U\u00e7gun","year":"2024","journal-title":"Exp. Clin. Transplant."},{"key":"ref14","first-page":"e14682","article-title":"Heart disease symptoms and health-related quality of life in pediatric heart transplant recipients: A serial multiple mediator analysis","volume-title":"Pediatric Transplantation","author":"Varni","year":"2024"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1867348\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:49:02Z","timestamp":1786099742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1867348\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":14,"alternative-id":["10.3389\/fpsyg.2026.1867348"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1867348","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1867348"}}