The mediating role of positive psychological resources in the relationship between social support and sleep quality among kidney transplant recipients: A cross-sectional study

Objective To examine the mediating role of positive psychological resources in the relationship between social support and sleep quality among kidney transplant recipients, and to provide evidence for the development of targeted sleep quality interventions. Methods A convenience sample of 343 stable kidney transplant recipients, including both inpatients and outpatients, was recruited from a tertiary hospital in Shenyang, Liaoning Province, China, between December 2024 and June 2025. Data were collected using a general information questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Social Support Rating Scale(SSRS), the Connor-Davidson Resilience Scale(CD-RISC), and the General Self-Efficacy Scale(GSES). Statistical analyses and path modeling were performed with SPSS 29.0 and AMOS 24.0. Results The prevalence of sleep disorders among kidney transplant recipients was 34.7%. Correlation analyses revealed that PSQI scores were negatively associated with social support, self-efficacy, and resilience (p < 0.01). Social support was positively correlated with self-efficacy and resilience (p < 0.01), and self-efficacy was positively correlated with resilience (p < 0.01). Path analysis showed that self-efficacy and resilience partially mediated the association between social support and sleep quality. The mediating effect of self-efficacy accounted for 51.5% of the total effect, while the mediating effect of resilience accounted for 52.4%. Conclusion Positive psychological resources, particularly self-efficacy and resilience, play a partial mediating role in the relationship between social support and sleep quality in kidney transplant recipients. These findings underscore the importance of incorporating psychological resource enhancement into clinical interventions to improve sleep outcomes in this population.