A Longitudinal Study On Predictors Of Posttraumatic Growth And Its Effects On Physical And Mental Rehabilitation In Patients After Renal Transplantation

Objective:The aim of the longitudinal study was to explore the factors that influence the level of posttraumatic growth(PTG)from the perspectives of the demographic,medical and psychological characteristics for patients who received renal transplant.Methods:A questionnaire survey was carried out in patients after renal transplantation at one month(T1)and six month(T2)in China during hospitalization.Survey tools include general information questionnaire,Posttraumatic Growth Inventory(PTGI),the Patient Health Questionnaire(PHQ-9),the Generalized Anxiety Disorder Questionnaire(GAD-7),the 10-item Connor-Davidson resilience scale(CD-RISC),the Perceived Social Support Scale(PSSS),the 4-item Perceived Stress Scale(PSS-4),the Ruminative Response Scale(RRS).Totally 180 patients were recruited,and 160 completed the follow-up measures,with a follow-up rate of 88.89%.Data were analyzed using SPSS.Statistical methods include descriptive statistics,paired t-test,Chi-square test,Pearson correlation and mixed effects linear regression model.Results:1.There are 88.3%patients reported positive PTG in T1,and 94.3%in T2.The mean score of posttraumatic growth at T1(M=77.96,SD=16.36)and T2(M=79.54.SD=17.58)have no significant difference(t=-1.302,P>0.05).2.Pearson correlation shows that PTG score in T1 were significantly and positively related to resilience(r=0.382,P<0.001)and social support(r=0.443.P<0.001).PTGI score in T2 is positively related to resilience and social support in both times.PTGI score in T2 is positively related to the score in T1(r=0.597,P<0.001).3.Univariate analysis indicated that all demographic and medical characteristics have no significance to posttraumatic growth;while for the psychological characteristics,resilience(B=0.82,P<0.001)and perceived social support(B=0.67,P<0.001)positively predict posttraumatic growth.However,perceived stress and rumination have no significance to PTG(both P>0.05).4.Multivariate analysis showed that all the demographic characteristics has no significant effect to the posttraumatic growth;resilience(B=0.65,P<0.001)and perceived social support(B=0.56,P<0.001)positively predict PTG,and perceived stress and rumination have no significance to PTG(both P>0.05).For the medical characteristics,having preoperative complications negatively predict posttraumatic growth(B=-5.23,P=0.028).Preoperative complications and social support can moderate the PTGI score as time going by.5.PTG is not significant to the recovering of physical symptoms(P>0.05),while it affect the incidence of anxiety(?2=7.541,P=0.021),but not related the incidence of depression(?2=3.926,P=0.130).Conclusions:1.There are no difference in the level of PTG in two times,88.3%patients reported positive PTG in T1,and 94.4%in T2.2.All demographic and medical characteristics have no significance to posttraumatic growth.3.Patients with high levels of resilience and social support also had high levels of PTG,which can positively predict PTG.4.PTG have no obvious effect on body health recovery for patients with renal transplantation after six month,while for the mental health,PTG have no effect on depression symptoms,but can reduce the occurrence of anxiety symptoms.