The relationship between post-traumatic growth and social participation in patients receiving maintenance dialysis: cross-lagged analysis of two waves

Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation. We included 157 RA patients (84.7% females; mean age 56.4 ± 13.9 years) who completed the Participation Scale, Brief Illness Perception Questionaire, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, 36-item Short Form Health Survey, and the Visual Analogue Scale. Multiple linear regressions and mediation analyses were used to analyze the data. In the final regression models, illness perception (β = .42; p ≤ .001) and functional disability (β = .21; p ≤ .05) were associated with social participation. Income (β = -.18; p ≤ .05) lost its significance when physical variables were added to the model, and pain (β = .24; p ≤ .05) and fatigue (β = -.24; p ≤ .05) when psychological distress was added. No significant role of anxiety, depression, disease activity, or age was identified using regression analyses. Illness perception mediated the association of pain, fatigue, anxiety, and depression with social participation, and the indirect effect varied from 65% to 98%. Illness perceptions may significantly diminish the impacts of pain, fatigue, anxiety, and depression on social participation in individual RA patients. Therefore, RA patients could benefit from psychological interventions aimed at tackling negative illness perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PurposeThis study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients’ social participation is investigated.MethodsA total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby.ResultsCompared to the general population, patients show lower levels of social participation in the domains “socio-cultural participation” and “participation in institutions,” while no significant differences for “social participation in the private sphere” and “social participation via social media” were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation.ConclusionsOur study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients’ reintegration into society through appropriate therapeutic interventions.

The main objective of this research is to determine the psychosocial differences between patients with knee pain or early osteoarthritis (EOA) and healthy subjects at risk of developing osteoarthritis. The secondary objective is to determine how psychosocial factors might influence pain and social participation in patients with EOA. A cross-sectional study was performed. Participants were divided according to the presence of pain or EOA. Pain intensity both at rest and walking, psychological variables such as anxiety and depression, and social participation were evaluated. A total of 105 participants were included (64 with knee pain and 41 without pain), with a mean age of 51.42 ± 5.92 (35 men and 70 women). Patients with knee pain had higher levels of anxiety (MD = −2.35; p < 0.01; d = 0.66) and depression (MD = −2.45; p < 0.01; d = 0.87), regardless of the presence of EOA. In addition, patients with higher depression levels had lower levels of social participation. The results revealed a relationship between the psychological variables, anxiety and depression, with knee pain and the onset of symptomatic OA, as well as an influence of depression levels on social participation. Improving these psychological characteristics may be useful in delaying the onset of symptomatic OA and enhancing social participation.

ObjectivesMultimorbidity is common among older adults from low- and middle-income countries (LMICs). Social participation has a role in protecting against negative health consequences, yet its association with multimorbidity is unclear, particularly in LMICs. Thus, this study investigated the relationship between physical multimorbidity and social participation among older adults across 6 LMICs.MethodCross-sectional, community-based data including adults aged 65 years and older from 6 LMICs were analyzed from the WHO Study on Global AGEing and adult health survey. The association between 11 individual chronic conditions or the number of chronic conditions (independent variable) and social participation (range 0–10 with higher scores indicating greater social participation; dependent variable) was assessed by multivariable linear regression analysis.Results14,585 individuals (mean age 72.6 [SD 11.5] years; 54.9% females) were included. Among individual conditions, hearing problems, visual impairment, and stroke were significantly associated with lower levels of social participation. Overall, an increasing number of chronic conditions was dose-dependently associated with lower levels of social participation (e.g., ≥4 vs 0 conditions: β = −0.26 [95% CI = −0.39, −0.13]). The association was more pronounced among males than females.DiscussionOlder people with multimorbidity had lower levels of social participation in LMICs. Future longitudinal studies are warranted to further investigate temporal associations, and whether addressing social participation can lead to better health outcomes among older people with multimorbidity in LMICs.

Background: Vitiligo is a stigmatizing, chronic, and usually progressive skin disorder that affects patients' quality of life and can interfere with their social participation. There are no studies in developing countries focusing on this aspect. Hence, we assessed social participation in patients with vitiligo and its associations with Vitiligo Quality of Life (VitiQoL), Vitiligo Area Score Index (VASI), and demographic and clinical characteristics. Methods: This cross-sectional study was conducted between 2013-2014 on 170 patients, in Razi Hospital, Tehran, Iran. In the pilot phase, the Persian version of the Participation Scale (P-scale) and VitiQoL questionnaire were validated with the backward-forward translation method. Results: Among 173 vitiligo patients, the mean participation score was 15.12 (SD=13.88, median=11). Overall, 91 patients (52.6%) had no significant restriction, 38 (22%) suffered from mild, 23 (13.3%) moderate, 20 (11.6%) severe, and 1 (0.6%) suffered from extreme restriction in participation. The association between VitiQol and P-scale was highly significant (r=0.58; p <0.001). This association was also observed with the three subscales of VitiQol, namely participation limitation (r=0.59, p <0.001), behavior (r=0.43, p <0.001), and stigma (r=0.23, P=0.002). We did not find a significant association between P-scale and demographic characteristics, overall VASI, and face, genitals, and exposed areas VASI. Conclusion: Although the majority of our patients perceived no or mild limitation in their social participation, the P-scale score was highly correlated with their quality of life and its components.

BackgroundIn the aftermath of the COVID-19 pandemic, nurses may report positive transformations due to the struggles faced during the outbreak, but the factors explaining this phenomenon remain understudied.ObjectiveConsidering the crucial role played by social ties and support to overcome adversity, the present research aims to explore social connectedness as a moderator between centrality of the COVID-19 outbreak and subsequent post-traumatic growth (PTG) in nurses. Specifically, the study sought to examine whether the longitudinal association between centrality of the COVID-19 outbreak and subsequent nurses' PTG differed according to the levels of social connectedness.MethodsThe global sample was composed of 180 nurses working in Portuguese healthcare institutions who answered online self-report surveys at two time points (baseline [T1] and follow-up at 6 months [T2]). Using self-report questionnaires, measures of centrality of the COVID-19 pandemic outbreak and social connectedness were administered at the baseline, and PTG reports were obtained at the six-month follow-up. Attrition rate from T1 to T2 was 73%.ResultsResults showed that social connectedness was a significant moderator in the relationship between centrality of the COVID-19 outbreak and PTG, with that association being stronger as the levels of social connectedness increased.ConclusionsThese findings shed light on the importance of social connectedness in fostering PTG among nurses after the COVID-19 outbreak. Psychological interventions aimed at enhancing nurses' constructive adjustment outcomes should acknowledge the occurrence of resilience and promote feelings of social connectedness and safeness to amplify potentially adaptive effects of the transformative nature of the pandemic.

Purpose After traumatic brain injury (TBI), individuals may face challenges in their social participation, self-awareness, and self-identity. However, positive life changes can also be experienced (i.e., post-traumatic growth). This study aimed to characterize the social participation, self-awareness, and self-identity of individuals with TBI displaying post-traumatic growth. Materials and methods Fifteen participants (male = 10, mean age = 49.7 years) with moderate to severe TBI (average years post-injury = 15.2) were included in this mixed-methods study. Self-report questionnaires were used to assess social participation, self-awareness, and self-identity. Qualitative data, collected using semi-structured interviews, were used to categorize participants into two groups: higher (n = 8) and lower (n = 7) post-traumatic growth. Descriptive statistics were used to characterize participants in each group in terms of their social participation, self-awareness, and self-identity. Results Participants with higher post-traumatic growth had increased social participation, higher self-awareness, and fewer negative discrepancies between their pre- and post-injury self-identities, compared to participants with lower post-traumatic growth. Conclusion This study contributes to a more comprehensive understanding of post-traumatic growth through the use of both qualitative and quantitative data. These findings can inform future research and development of programs to promote post-traumatic growth post-TBI.

This study was to explore the mediating effect of resilience on the relationship between dyadic coping and post-traumatic growth in patient-spousal caregiver dyads living with coronary heart disease (CHD). A cross-sectional study was conducted from December 2022 to June 2023. Three hundred eighteen young and middle-aged patient-spousal caregiver dyads from a tertiary hospital in China participated. The dyadic participants were evaluated using self-report questionnaires on dyadic coping, resilience and post-traumatic growth. A significant actor effect was observed, in which dyadic coping in patients was associated with their own post-traumatic growth; this relationship was partially mediated by both the patient's and the partner's resilience. Furthermore, in the examination of partner effects, the association between dyadic coping in spousal caregivers and post-traumatic growth in patients was found to be completely mediated by the resilience of both the patients and the caregivers. The findings suggest that the dyadic coping, resilience and post-traumatic growth of patients and their spousal caregivers display interactive effects. Healthcare providers treating CHD should regard patient-spousal caregiver dyads as a whole and implement interventions that focus on improving positive dyadic coping and resilience to promote post-traumatic growth. This paper found that the patients with CHD and their spousal caregivers exhibited low levels of post-traumatic growth, with both groups demonstrating mediating and interactive effects via resilience. The findings offer valuable insights to support the early primary identification and implementation of more effective intervention strategies aimed at fostering post-traumatic growth in CHD patient-spousal caregiver dyads. Not applicable.

Introduction. Social participation is a critically important aspect of life in older adults. Also, it is one of the major subjects of research in the field of aging. Old age and its implications can have both positive and negative effects on social participation in the elderly population. Older oncology patients also face additional challenges in achieving active aging and full social participation. The goal of this study was to establish the prevalence and variety of social participation of oncology patients over the age of 60, as well as to determine any possible correlation between specific demographic characteristics and social participation. Material and Methods. The study included 100 persons aged 60 to 92 treated for malignant diseases. The Maastricht social participation profile and a demographic questionnaire designed for the purpose of this study were used as research instruments. Data analysis included the t-test for independent samples, correlation analysis, linear regression analysis, and one way analysis of variance. Results. Persons over the age of sixty have a low level of social participation, particularly in the domains of contacts with friends and family. A statistically significant difference was found in social participation in regard to different demographic characteristics: type of residence (t = 6.765, p &lt; .01) and disability (t = 5.663, p &lt; .01), and age (R = 0.478, p &lt; .01). There were no statistically significant differences in regard to gender, education and presence/ absence of chronic disease. Conclusion. Oncology patients over the age of 60 have a very low social participation. Considering its importance for health and quality of life in the elderly, it is crucial to develop a support system for these persons and to recognize the significance of including social support in the care of this population.

BackgroundSocial participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients’ functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients.MethodsThis cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants’ data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients’ social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups.ResultsThree months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05).ConclusionThese results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

Characterising Posttraumatic Growth in Individuals With TBI Based on Social Participation, Self-Awareness, and Self-Identity

The diagnosis and treatment of cancer triggers not only a negative psychological response for the patient, but also a positive psychological outcome. Positive dyadic coping, as a form of coping for mental health outcomes, can maintain or reestablish internal stability between the patient and his or her spouse, resulting in positive physical and psychological changes. However, there is a paucity of research on body image, dyadic coping, and post-traumatic growth in breast cancer patients. The purpose of this study was to explore the relationship and pathways between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A cross-sectional study was conducted from November 2022 to November 2023 at a tertiary care hospital in Wuxi, Jiangsu, China. This study was conducted among 154 breast cancer patients treated at the Affiliated Hospital of Jiangnan University, all of whom completed demographic and clinical information questionnaires, Body image self-rating questionnaire for breast cancer (BISQ-BC), Dyadic Coping Inventory (DCI) and Post Traumatic Growth Inventory (PTGI). A Pearson correlation analysis was used to explore the relationship between body image, dyadic coping, and post-traumatic growth. Structural equation modeling was used to analyze the path relationships among the three and to explore the mediating role of dyadic coping. The level of body image was negatively correlated with post-traumatic growth (r = -0.462, p < 0.01); and the level of body image was negatively correlated with dyadic coping (r = -0.308, p < 0.01). And dyadic coping was positively associated with post-traumatic growth (r = 0.464, p < 0.01). The structural equation modeling results supported the mediation model with the following model fit indices, chi-square to degrees of freedom ratio (χ2/df = 2.05), goodness of fit index (GFI = 0.93), comparative fit index (CFI = 0.99), canonical fit index (NFI = 0.93), incremental fit index (IFI = 0.99), non-canonical fit index (TLI = 0.99) and the root mean square of the difference in approximation error (RMSEA = 0.03). Body image and dyadic coping directly affected post-traumatic growth (β = -0.33, p < 0.05; β = 0.43, p < 0.05). And body image indirectly influenced post-traumatic growth through dyadic coping (β = -0.17, p < 0.05). Interconnections between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A preliminary validation of the mediating role of dyadic coping between body image and post-traumatic growth, body image can have an impact on dyadic coping, which in turn can have an impact on post-traumatic growth. Whereby higher levels of dyadic coping in patients may also be associated with higher levels of post-traumatic growth, whereas body image disturbance may impede levels of post-traumatic growth.

Social participation is considered to be an objective parameter for evaluating the success of transplantation. This study explores the association between posttransplant factors (kidney function, perceived side effects of immunosuppressive treatment, comorbidity, physical and mental health-related quality of life [HRQoL]) and social participation in patients 3 months to 6 years after kidney transplantation (baseline) and their impact on graft loss and mortality for up to 10 years (follow-up). At baseline, 331 patients provided their socioeconomic and medical data (comorbidity, kidney function) and completed the end-stage renal disease symptom checklist (perceived side effects), the Short Form Health Survey-36 and the Participation Scale. At follow-up, information on all-cause graft-loss and mortality was noted. Binary logistical regression exploring the effects of the independent variables on social participation and Cox regression analyses determining whether social participation predicted graft loss and mortality were performed. Restrictions in social participation were associated with living alone, poorer kidney function, lower perceived side effects of corticosteroids, higher perceived cardiac and renal dysfunction, higher perceived posttransplantation distress, lower physical HRQoL, and fewer working hours. Restrictions in social participation increased the risk of all-cause graft loss 2.29-fold and the risk of all-cause mortality 11.94-fold during follow-up. Education, kidney function, and comorbidity also increased the risk for poor patient outcome. Kidney function, perceived side effects, comorbidities, and HRQoL affect social participation in patients after kidney transplantation. Additionally, social participation has a positive effect on long-term patient outcomes, decreasing the odds of graft loss and mortality over 10 years.

ObjectiveSystemic lupus erythematosus (SLE) can negatively impact patients’ social participation. The aim of this study was to identify the determinants of social participation in patients with SLE.MethodsA cross-sectional evaluation was carried out in 100 adult outpatients with SLE enrolled in the multicentre psychosocial lupus (Psy-LUP) study. Participants completed the following standardised questionnaires: Participation Scale (social participation); Zimbardo Time Perspective Inventory; Sarason’s Social Support Questionnaire; Couples Satisfaction Index; Brief Illness Perceptions; Short Form-36 and Lupus-QoL. Stepwise multivariate regression analysis identified determinants of social participation.Results92 women and eight men were included. Mean age was 44 years, mean SLE duration was 14 years, 52% of patients had a history of lupus nephritis and 38% were currently receiving immunosuppressants and/or biologics. 73% were in a couple and 64% were employed. Social participation was reduced in 29% of patients (compared with 46% in rheumatoid arthritis or multiple sclerosis), who reported different illness perceptions than those with preserved social participation. In multivariate linear regression, female sex (p=0.006), smoking (p=0.04), osteoporotic fractures (p=0.03), anti-cardiolipin antibodies (p=0.01) and ‘Past Negative’ time perspective (p=0.002) were associated with reduced social participation, while haematological involvement (p=0.005) and ‘Present Hedonistic’ time perspective (p=0.02) were protective. Reduced social participation was also associated with illness representations and with lower health-related quality of life (HR-QoL) scores.ConclusionsSocial participation is frequently altered in patients with SLE and correlates with illness representations, time perspective and HR-QoL. Psychological support and therapeutic education may help improve patients’ time perspective.Trial registration numberNCT03913754.

BackgroundThere is limited understanding regarding the patterns and trajectories of social participation and their associations with medical care utilization among rural older adults. We aimed to investigate the patterns and trajectories of social participation and their associations with medical care utilization among rural older adults in China using longitudinal data.MethodsIn this longitudinal study, we used data from 1600 participants aged 60 years and above in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We included participants with social participation information in 2011 (T1) as the baseline and followed them up in 2014(T2) and 2018(T3). Latent profile analysis (LPA) and latent transition analysis (LTA) were employed to identify the latent classes of social participation and the transition probabilities between these classes. Multinomial logistic regression was used to examine the predictors of transitions, while a two-part model and cross-lagged model were utilized to clarify the longitudinal relationship between social participation and medical care utilization among rural older adults.ResultsThree social participation classes were identified by LPA: low, moderate, and high social participation. The high social participation class exhibited strong stability, with rare transitions to other classes. Subjective economic status, self-rated health, and the number of chronic diseases significantly predicted social participation transition patterns (P < 0.05). Regarding outpatient care utilization, social participation consistently predicted more frequent outpatient visits in all waves (P < 0.05) but was associated with higher outpatient expenses only at T3 (P < 0.05). However, no significant association was observed between social participation and inpatient care utilization. This finding was further supported by cross-lagged modeling, demonstrating significant effects of social participation on outpatient care utilization (β = 0.016 to 0.018, SE = 0.004, P < 0.001).ConclusionsThis research reveals the social participation dynamics in rural older adults and their effects on medical care utilization in China. Social participation can significantly promote outpatient care utilization among rural older adults. Targeted policy and practice are needed for those with low levels of social participation in rural areas.