The mediating role of self-efficacy in the association between social support and eHealth literacy among kidney transplant recipients.

BACKGROUND

Kidney transplant recipients face complex self-management challenges that require a high level of health literacy, particularly in digital health contexts. However, the mechanisms underlying eHealth literacy in this population remain underexplored. This study aimed to examine the association between social support and eHealth literacy and to investigate the mediating role of self-efficacy in this relationship among kidney transplant recipients in China.

METHODS

A cross-sectional survey was conducted in June 2025 among 236 kidney transplant recipients at a tertiary hospital in northeastern China. Eligible participants had undergone kidney transplantation at the study hospital between January 2022 and May 2025. Standardized self-report questionnaires were used to measure social support, self-efficacy, and eHealth literacy. Mediation analysis was performed using the PROCESS macro for SPSS, adjusting for relevant covariates.

RESULTS

After adjustment for covariates, social support was significantly associated with self-efficacy (B = 0.351, p < 0.001) and eHealth literacy (total effect: B = 0.213, p < 0.001). When self-efficacy was included in the model, the direct association between social support and eHealth literacy remained significant (direct effect: B = 0.143, p < 0.001). The indirect effect through self-efficacy was also significant (B = 0.070, p < 0.001), indicating findings consistent with a partial mediation pattern.

CONCLUSION

Among kidney transplant recipients, social support and self-efficacy were positively associated with eHealth literacy, and self-efficacy partly accounted for the association between social support and eHealth literacy. These findings suggest that perceived social support and self-efficacy may represent promising targets for interventions aimed at enhancing eHealth literacy and digital health engagement in this population.