The Relationship Between Post-Traumatic Growth and Social Participation in Patients Receiving Maintenance Dialysis: Cross-Lagged Analysis of Two Waves

Purpose:Social participation and post-traumatic growth (PTG) both exert beneficial effects on well-being of patients receiving maintenance dialysis. However, the temporal directionality of their association has remained unexamined. This study aimed to examine the bidirectional, longitudinal relationship between PTG and social participation over 1-year period among patients receiving maintenance dialysis. Methods:Research data were collected from patients receiving dialysis treatment for over 3 months at two tertiary hospitals in China. A total of 193 participants completed the baseline survey, and 147 completed the second-wave survey. Self-reported questionnaires were delivered to assess their PTG and social participation. Cross-lagged analysis was used to examine the possible relationship between PTG and social participation. Results:After adjusting for confounding factors, a unidirectional linear relationship was observed: higher levels of PTG at baseline were associated with greater social participation over time (β = 0.290, 95% CI: 0.151-0.430, p < 0.001), whereas baseline social participation was not significantly associated with subsequent PTG. Conclusions:This study revealed low levels of social participation among patients receiving maintenance dialysis. Based on the cross-lagged analysis, PTG appears to play a contributing role in improving social participation over time.