Posttraumatic growth in parents of children who underwent liver transplantation: a cross-sectional study

Confronted with the traumatic experience of a child’s liver transplantation, parents may experience positive psychological changes alongside distress. This study aimed to: assess the level of posttraumatic growth (PTG) in this population, and identify factors associated with PTG, focusing on deliberate rumination, intrusive rumination, and social support. This cross-sectional study involved parent-caregivers of young children (≤ 3 years) after their first liver transplantation at a Chinese tertiary hospital (May 2023–June 2024). Data were analyzed using SPSS 25.0. Group comparisons (t-tests/ANOVA), correlation analyses, and a multivariable stepwise linear regression were performed to identify influencing factors associated with PTG. Of 146 parents recruited, 134 provided valid responses (91.8% response rate). The mean PTG score was 67.23 (SD = 13.89), with 25.4% reporting low, 14.9% moderate, and 59.7% advanced growth. Deliberate rumination and social support were strongly correlated with PTG (r = 0.371 and 0.368, respectively; both p < 0.01), while intrusive rumination showed only a weak correlation (r = 0.188, p < 0.05). Multiple linear regression revealed that deliberate rumination (β = 0.341, p < 0.001) and social support (β = 0.309, p < 0.001) were the strongest predictors of higher PTG. Additional predictors included being a liver transplant donor (vs. non-donor), being a father (vs. mother), and providing 19–24 h of daily care (vs. 6–12 h). The model explained 35.3% of the variance in PTG (F = 13.957, p < 0.001). This study demonstrates that parents of children who underwent liver transplantation can experience substantial PTG. Deliberate rumination and perceived social support were identified as core, modifiable predictors. Furthermore, specific caregiving contexts, such as serving as the liver donor, the father’s role, and prolonged daily care, were associated with higher PTG. Consequently, clinical interventions should primarily target the core psychological and social factors, for example, by facilitating deliberate rumination through narrative or mindfulness exercises and by strengthening support through family and peer networks. Integrating such strategies into family-centered care can effectively promote PTG and psychological well-being in this population.