4.4 Article

Multi-level correlates of received social support among heart transplant recipients in the international BRIGHT Study: a secondary analysis

Journal

EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING
Volume 21, Issue 8, Pages 857-867

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/eurjcn/zvac041

Keywords

Heart transplant; Social support

Funding

  1. International Transplant Nurses Society
  2. International Society for Heart and Lung Transplantation
  3. Swiss Academy of Medical Sciences
  4. Astellas Pharma
  5. European Union Regional Development Funds (EURDF)

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This study aimed to explore the variation in received emotional and practical social support among heart transplant recipients at the country and center levels, as well as assessing the multi-level correlates. The study found that social support varies at both the country and center levels and is associated with patient-level, micro-level, and meso-level factors.
Aims Social support is critical in follow-up of patients after heart transplant (HTx) and positively influences well-being and clinical outcomes such as medication adherence. The purpose of this study was to (i) explore received social support variation (emotional and practical) in HTx recipients at country and centre level and (ii) to assess multi-level correlates. Methods and results Secondary data analysis of the multi-level cross-sectional BRIGHT study was conducted in 36 HTx centres in 11 countries. Received social support related to medication adherence was measured with emotional and practical sub-scales. The Conceptual Model of Social Networks and Health guided selection of patient, micro (interpersonal and psychosocial), meso (HTx centre) and macro-level (country health system) factors. Descriptive statistics, intraclass correlations, and sequential multiple ordinal mixed logistic regression analysis were used. A total of 1379 adult HTx recipients were included. Patient level correlates (female sex, living alone, and fewer depressive symptoms) and micro-level correlates (higher level of chronic disease management and trust in the healthcare team) were associated with better emotional social support. Similarly, patient level (living alone, younger age, and male sex), micro-level and meso-level (patient and clinician-rated higher level of chronic disease management) were associated with better practical social support. Social support varied at country and centre levels for emotional and practical dimensions. Conclusions Social support in HTx recipients varies by country, centre, and was associated with multi-level correlates. Qualitative and longitudinal studies are needed to understand influencing factors of social support for intervention development, improvement of social support, and clinical outcomes.

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