{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:42:15Z","timestamp":1784133735428,"version":"3.55.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Benefit finding (BF) improves quality of life in maintenance hemodialysis (MHD) patients, yet population heterogeneity remains understudied. This study explores how self-efficacy and social support jointly influence BF patterns and identifies distinct patient subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multi-center cross-sectional study was conducted from April to September 2023 at five tertiary hospitals in Shanghai, China, enrolling 352 MHD patients. Data from the Benefit Finding Scale, General Self-Efficacy Scale, and Perceived Social Support Scale were used to construct a Classification and Regression Tree (CART) model employing five-fold cross-validation, with a maximum depth of 3 and a minimum leaf node size of 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CART model (R\u00b2=0.278) identified five distinct BF subgroups (<jats:italic>p<\/jats:italic>&amp;lt;0.001): Low Self-Efficacy Constrained Group, Psychological Resource Deficient Group, Internally Belief Driven Group, Balanced Resource Adaptation Group, and Resource Integrated Advantage Group, each characterized by unique combinations of self-efficacy and social support. Significant differences were observed among the subgroups in terms of gender(<jats:italic>p<\/jats:italic>=0.045), education level(<jats:italic>p<\/jats:italic>=0.010), and employment status(<jats:italic>p<\/jats:italic>=0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BF levels in MHD patients demonstrated significant variations influenced by the combined effects of self-efficacy and social support. The decision tree model successfully identified patient subgroups with distinct psychological resource configurations. These findings provide a theoretical foundation for implementing stratified and personalized psychological interventions in clinical practice. Clinicians can identify and prioritize vulnerable patients who simultaneously lack self-efficacy and social support, offering them targeted positive psychological interventions that may potentially improve treatment adherence and long-term prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1665458","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:32:04Z","timestamp":1758173524000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Heterogeneity of benefit finding in maintenance hemodialysis patients: a decision tree-based subgroup analysis of self-efficacy and social 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