Health Literacy, Disease Perception, Coping Style, and Self-Management in Kidney Transplant Recipients: A Cross-Sectional Study

Kidney transplantation (KT) is a life-saving procedure that requires recipients to maintain long-term self-management and adapt psychologically to optimize health outcomes. However, gaps remain in understanding how health literacy, disease perception, and coping styles influence self-management behaviors in this population. This study examined the interrelationships among health literacy, disease perception, coping style, and self-management behavior in KT patients in China. A descriptive cross-sectional design was employed with 320 KT recipients who completed a structured questionnaire assessing the four study variables. Data were analyzed using descriptive statistics, independent-sample t-tests, ANOVA, and correlation analyses. Findings show that participants demonstrated moderate health literacy, with relatively strong communication and information-seeking skills, but lower motivation to improve health and limited financial capacity for healthcare. Disease perception was moderate, indicating a serious appraisal of the condition. Confrontation was the most commonly adopted coping style, followed by acceptance–resignation, and avoidance. Overall, self-management behavior was low, particularly in physical activity and psychosocial domains. Gender was significantly associated with health literacy; age, comorbidity, and employment status were related to coping styles; and gender and marital status influenced self-management. Disease perception correlated negatively with health literacy and self-management, while health literacy correlated positively with self-management. Positive coping styles were linked to lower disease perception and improved self-management. Overall, enhancing health literacy and promoting adaptive coping styles may strengthen self-management among KT recipients. Tailored nursing interventions, improved follow-up systems, and greater social and policy support are recommended to facilitate successful long-term adaptation. Future work should test the proposed relationships longitudinally and with mediational modeling to clarify causal pathways and potential moderators in diverse Chinese settings.