Factors influencing Taiwanese patients’ resilience and satisfaction with dialysis: a cross-sectional survey

BACKGROUND: Resilience is a crucial feature of the nursing workforce, particularly among those working in dialysis care. Patients with end-stage kidney disease (ESKD) or chronic kidney disease need to be able to adjust and survive despite hardship. Studies have shown that enhanced resilience is correlated with increased life satisfaction and psychological endurance in individuals undergoing hemodialysis. Resilience is an adaptive coping capacity that can strengthen the benefit of structured care on trust while buffering reliance on interpersonal support, potentially yielding opposing moderation patterns across pathways. This study investigated the psychosocial determinants that influence the satisfaction and resilience of patients in dialysis and explored global challenges, including healthcare environment, provider-patient interactions, and medical procedures in Taiwan. METHODS: A cross-sectional survey was conducted with 380 stable dialysis patients who had undergone dialysis for more than 3 months without complications at a medical center in Taiwan between September and October 2022. Participants completed Brief Resilience Scale (BRS) questionnaires assessing resilience, trust, treatment satisfaction, and perceived quality of environmental conditions. The questionnaires were primarily self-administered (paper-based). The data were analyzed using partial least squares structural equation modeling (PLS-SEM) to evaluate relationships and moderating effects. Analysis with PLS-SEM was selected for its suitability to prediction-oriented modeling with interaction (moderation) effects and complex latent constructs. RESULTS: Resilience significantly enhanced the positive relationship between medical processes and patient trust but negatively moderated the association between nursing care and trust. High-quality environmental facilities (featuring cleanliness, comfort, privacy, adequate physical layout, and adequate equipment in the dialysis unit) and physician interactions were crucial factors that strengthened patient resilience. Moreover, patient trust strongly predicted satisfaction with dialysis care. Demographic variables, including age, gender, and dialysis modality, were not significant predictors of satisfaction. CONCLUSIONS: Resilience substantially influenced patient trust and satisfaction in dialysis care. The integration of resilience-focused strategies, enhancement of care environments, and facilitation of effective communication among healthcare providers are recommended as essential measures for optimizing patient outcomes in chronic dialysis settings. Negative moderation suggests that, when resilience is high, patients may rely more extensively on internal coping and less on interpersonal reassurance, thus weakening the incremental effects of nursing support on trust. The findings may inform settings with comparable dialysis care structures and frameworks of patient-experience monitoring.