The impact of social support on the mental health and quality of life of living-related liver donors: the mediating role of family functioning
Ji-Yue Li, Ya-Ru Fan, Hai-Ming Zhang, Zhi-Jun Zhu, Yue-Xian ShiAbstract
Objectives:
Living-related liver transplantation poses significant physiological and psychosocial challenges for donors. Although postoperative physical recovery is rigorously monitored, the mechanisms underlying donors’ long-term psychological well-being remain underexplored. Specifically, the interplay between social support and family dynamics in shaping donor outcomes has not been fully elucidated. This study aimed to investigate the associations among social support, family functioning, mental health, and quality of life in living-related liver donors. A key objective was to determine whether family functioning mediated the relationship between social support and donors’ psychosocial outcomes.
Methods:
This study used a cross-sectional survey to assess social support, family function, mental health, and quality of life in 483 living-related liver donors in China. Validated psychometric instruments—including the 36-Item Short Form Health Survey, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Multidimensional Scale of Perceived Social Support, and Family Adaptation, Partnership, Growth, Affection, and Resolve Index (Family APGAR)—were utilized to assess quality of life, depression, anxiety, social support, and family functioning, respectively.
Results:
The prevalence of psychosocial distress was notable, with 43.1% and 47.8% of donors exhibiting symptoms of depression and anxiety, respectively. Furthermore, a substantial proportion of donors reported suboptimal social support across different dimensions (40.5%–52.2%) and moderate-to-severe family dysfunction (38%). Analyses revealed that family functioning significantly mediated the positive effects of social support on mental health and quality of life. Social support not only directly improved outcomes but also exerted an indirect protective effect by enhancing family functioning.
Conclusions:
Psychosocial morbidity remains high among living-related liver donors. The findings highlight that family functioning is a critical mechanism through which social support influences donors’ well-being. Consequently, clinical interventions should extend beyond the individual donor to include family-centered strategies, thereby optimizing long-term psychosocial adaptation.