title: Evolution of post-traumatic growth during the first 12 months of dialysis: A longitudinal study.
abstract: BACKGROUND
  Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients.
  
  
  OBJECTIVE
  To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress.
  
  
  METHODS
  A prospective, longitudinal, observational study.
  
  
  METHODS
  The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups.
  
  
  RESULTS
  Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress.
  
  
  CONCLUSIONS
  Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.
authors.affiliation: School of Nursing Vitoria-Gasteiz, Basque Health Service-Osakidetza, University of the Basque Country, Vitoria-Gasteiz, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Ruiz de Alegría
authors.affiliation: Department of Social Psychology and Methodology of Behaviour Sciences, University of the Basque Country, Vitoria-Gasteiz, Spain.
authors.forename: Nekane
authors.initials: N
authors.lastname: Basabe
authors.affiliation: School of Nursing Vitoria-Gasteiz, Basque Health Service-Osakidetza, University of the Basque Country, Vitoria-Gasteiz, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: De Lorenzo
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000523:psychology* / Q000592:standards; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D013030:Spain; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Haemodialysis; Peritoneal dialysis; Post-traumatic growth; Post-traumatic stress; Psychological