Psychological and clinical correlates of posttraumatic growth in cancer: A systematic and critical review

Chemotherapy and Related Female Sexual Dysfunction: A Review of Literature

Context: Cancer is a detrimental illness that affects patients’ quality of life and other aspects of a healthy life. Chemotherapy has been shown to have a direct and indirect effect on the sex organs of women. Evidence Acquisition: We searched in databases including PubMed, Scopus, and Google scholar. The keywords for our search were as follows: “Chemotherapy” OR “Cancer treatment” AND “Sexual dysfunction “OR “Sexuality” OR "libido” OR "dyspareunia" OR "orgasmic disorder" OR "sexual disorder". We evaluated the articles based on their abstract and 92 studies were selected and used in the present study. Results: Chemotherapeutic agents damage ovaries and could cause premature ovarian failure. Furthermore, chemotherapy disturbs the femininity aspects of patients and reduces their libido. In this review article, we aimed at a better understanding the effect of chemotherapy on the sexual function of female cancer survivals. Conclusions: In conclusion, chemotherapy is one of the most common cancer treatments affecting sexual health aspects, such as decreased libido, arousal and orgasm, dyspareunia, dysfunction of the sexual response cycle before puberty, and vulvovaginal atrophy. However, many patients are reluctant to discuss their sexual problems.

Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: A randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life

Background and aim

Head and neck cancer patients are vulnerable to various psychological complications due to the effects of both cancer itself and cancer treatment on patients’ appearance and physical well-being. Nevertheless, few data have been obtained on effective psychosocial interventions that could protect this group of cancer patients’ psychological well-being. Therefore, this three-armed, parallel-group, double-blind, randomized control trial (RCT) aims to evaluate and compare the effects of acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR) on positive psychology (such as posttraumatic growth [PTG], hope, and optimism), quality of life (QoL), and psychological complications (depression, anxiety, and experiential avoidance) among newly diagnosed head and neck cancer patients.

Methods and analysis

This RCT will target newly diagnosed head and neck cancer patients who have been treated only with surgery or who have not yet received any treatment. In total, 120 patients who meet all of the study’s inclusion criteria and none of its exclusion criteria will be randomly assigned into three groups—an ACT group, an MBSR group, and a treatment-as-usual control group—at a 1:1:1 allocation ratio. Participants in the two intervention groups (the ACT and MBSR groups) will undergo an eight-week group intervention program. During this program, each intervention will comprise eight modules based on ACT and MBSR, respectively. Outcome assessments will be performed across a three-point timeline, including before the intervention (t₀), immediately after the psychosocial intervention at eight weeks (t₁), and six months after the intervention (t₂). The primary outcome that will be assessed during this RCT is PTG. Meanwhile, the secondary outcomes that will be evaluated in this study are such as QoL, hope, optimism, depression, anxiety, and experiential avoidance.

Trial registration number

NCT04800419 (ClinicalTrials.gov). Registered on March 16, 2021.

Posttraumatic growth and well-being among people living with HIV: A systematic review and meta-analysis in recognition of 40 years of HIV/AIDS

OBJECTIVES

This systematic review and meta-analysis aimed to synthesize, analyze, and critically review existing studies on the relationship between posttraumatic growth (PTG) and psychological well-being (operationalized either via positive or negative well-being indicators) among people living with HIV (PLWH). We also investigated whether this association varies as a function of socio-demographic, clinical characteristics, and study publication year.

METHOD

We conducted a structured literature search on Web of Science, Scopus, MedLine, PsyARTICLES, ProQuest, and Google Scholar. The most important inclusion criteria encompassed quantitative and peer-reviewed articles published in English.

RESULTS

After selection, we accepted 27 articles for further analysis (N = 6333 participants). Eight studies used positive indicators of well-being. The other 19 studies focused on negative indicators of well-being. Meta-analysis revealed that there was a negative weak-size association between PTG and negative well-being indicators (r = - 0.18, 95% CI [- 0.23; - 0.11]) and a positive medium-size association between PTG and positive well-being measures (r = 0.35, 95% CI [0.21; 0.47]). We detected no moderators.

CONCLUSIONS

The present meta-analysis and systematic review revealed expected negative and positive associations between PTG and negative versus positive well-being indicators among PLWH. Specifically, the relationship between PTG and positive well-being indicators was more substantial than the link between PTG and negative well-being measures in these patients. Finally, observed high heterogeneity between studies and several measurement problems call for significant modification and improvement of PTG research among PLWH.

Dyadic effects of rumination and self-disclosure on posttraumatic growth in newly diagnosed gynecological cancer couples: an actor-partner interdependence modeling approach

OBJECTIVE

To examine the dyadic effects of rumination and self-disclosure on posttraumatic growth among newly diagnosed gynecological cancer couples.

METHODS

This cross-sectional study recruited 400 newly diagnosed gynecological cancer couples from a tertiary general hospital from July to December 2020. Questionnaires were administered to collect information on demographic and cancer-related characteristics, rumination, self-disclosure, and posttraumatic growth. The actor-partner interdependence model was used to explore the dyadic effects of rumination and self-disclosure on posttraumatic growth.

RESULTS

Gynecological cancer survivors reported more posttraumatic growth than their spouses. The patients' deliberate rumination and self-disclosure and spouses' self-disclosure had actor and partner effects on their own and their spouses' posttraumatic growth. Besides, the patients' intrusive rumination and spouses' deliberate rumination had actor effects on their own posttraumatic growth.

CONCLUSIONS

Spouses' posttraumatic growth was influenced by their own and their wives' deliberate rumination and self-disclosure, while survivors' posttraumatic growth was affected by their own deliberate rumination, intrusive rumination, self-disclosure, and their spouses' self-disclosure. Promoting deliberate rumination and self-disclosure could facilitate the couples' posttraumatic growth. Besides, reducing intrusive rumination may be useful for the survivors and indirectly contribute to spouses' posttraumatic growth. This study indicates that couple-centered interventions may be crucial and more effective in facilitating posttraumatic growth among newly diagnosed gynecological cancer couples.

Looking toward the future: Approaching care of the aging CF patient

Caring for people with cystic fibrosis has changed considerably since the first description of the disorder and continues to evolve in the era of highly effective modulator therapy. These new treatment advancements are resulting in improved health outcomes in an ever-growing adult population with improved long-term survival. This study explores potential comorbidities and mental health implications associated with increased longevity and survivorship. It also considers the need for further evolution in patient-centered care with an expanded healthcare team in a more virtually connected world.

Does perceived post-traumatic growth predict better psychological adjustment during the COVID-19 pandemic? Results from a national longitudinal survey in the USA

Perceiving that one has grown in positive ways following highly stressful experiences (perceived posttraumatic growth; PPTG) is common and sometimes--but not always--related to psychological wellbeing. However, PPTG is typically studied cross-sectionally and well after the stressful experience has passed; how PPTG might relate to wellbeing over time in an unprecedented, ongoing worldwide disaster such as the COVID-19 pandemic remains unknown. Thus, the current study sought to answer whether, in the midst of the pandemic, PPTG relates to subsequent wellbeing, broadly defined. Participants were N = 1544 MTurk workers who completed a five-wave (T1-T5) six-month longitudinal study. Current analyses focused on T2-T5 (ns = 860-712). At each time point, participants completed self-report measures of PPTG and wellbeing (depression, anxiety, stress, positive states of mind, alcohol use, posttraumatic stress). In cross-lagged panel models, PPTG was largely unrelated to subsequent wellbeing. Somewhat more evidence was found that increasing distress led to increases in PPTG, suggesting perceptions of growth may serve as a coping mechanism. PPTG does not appear to benefit adjustment to the COVID-19 pandemic and may simply reflect efforts to manage distress.

Post-Traumatic Growth during COVID-19: The Role of Perceived Social Support, Personality, and Coping Strategies

Although many studies on mental health have been conducted among various populations during the COVID-19 pandemic, few studies have focused on post-traumatic growth (PTG) in the general population. The current study aimed to explore whether perceived social support, personality, and coping strategies are associated with PTG in the COVID-19 pandemic period. The study also investigated whether coping strategies mediate the relations between perceived social support, personality, and PTG. A total of 181 participants (M_age = 24) completed the self-report questionnaire online, which was distributed via various online channels, mainly in China and Sweden. The relations between the study variables were examined with correlation analyses and a multiple mediation analysis. Results showed that more than half of the participants (60.8%) reported experiences of PTG during the pandemic. Additionally, perceived social support, personality traits (extraversion, emotional stability, agreeableness, and conscientiousness) and coping strategies (problem-focused coping, emotion-focused coping, and social support coping) were positively correlated with PTG. In addition, coping strategies (problem-focused coping, emotion-focused coping, and avoidance coping) mediated the relations between perceived social support, personality traits and PTG. Theoretical and practical implications of this study are discussed, concluding that the findings of this study have the potential to guide intervention efforts to promote positive change during the pandemic.

Evaluating a Pilot Culturally Sensitive Psychosocial Intervention on Posttraumatic Growth for Chinese American Breast Cancer Survivors

This study investigated the potential benefit of a pilot culturally sensitive group support intervention, named Joy Luck Academy (JLA), in fostering posttraumatic growth among Chinese American breast cancer survivors. Eighty-six Chinese American breast cancer survivors participated in an eight-week single-arm pre-/post-test trial of an intervention program, which included educational lectures and peer mentor support. The JLA participants were compared with an independent sample of 109 Chinese American breast cancer survivors who went through routine care. Both groups completed baseline and eight-week follow-up assessments of the five facets of posttraumatic growth (meaningful interpersonal relationships, finding new possibilities in life, personal strength, appreciation of life, and spirituality). From baseline to follow-up, the JLA participants displayed significant improvements in the total score of posttraumatic growth, meaningful interpersonal relationships, appreciation of life, finding new possibilities in life, and personal strength. In contrast, the routine care participants showed no significant change in any of these outcome variables. The findings suggest the potential benefit of a culturally sensitive group support intervention in facilitating posttraumatic growth for Chinese American breast cancer survivors, indicating the need for a randomized controlled trial. The educational lectures and peer mentor support may be adapted to tailor the needs of other ethnic minority cancer patients.

Resilience across the Transition to Cancer Survivorship

Resilience is highly relevant in the context of cancer, and understanding how survivors adapt and potentially thrive following their diagnosis and treatment may provide insights into better supports and interventions to promote healthier survivorship. In this paper, we characterize two different ways to conceptualize and study resilience in cancer survivorship, as a trait and as a process. We focus specifically on the transition from active treatment to post-treatment survivorship. We present data from 225 cancer patients transitioning from active treatment (baseline assessment) to early survivorship (6-month follow-up). Results demonstrate that resilience assessed as a trait at baseline was unrelated to changes in survivors' mental or physical wellbeing at follow-up, but did predict a decline in social satisfaction and spiritual wellbeing over time. However, when resilience is conceptualized as a dynamic process, the sample showed substantial resilience on multiple aspects of wellbeing. We suggest that different ways of conceptualizing resilience--as a trait versus as a dynamic process--may lead to very different conclusions and discuss future research directions for cancer survivors and for science of resilience.

The Interplay Between Individual and Dyadic/Common Coping in Female Patients With Cancer

Abstract. Both individual and dyadic coping behaviors are important for adaptation to a severe illness. However, there is a theoretical controversy regarding the interplay between these two forms of coping. In this cross-sectional study, we examined (a) whether recently diagnosed cancer patients engage mostly with one form of coping or whether they use both in parallel; (b) the relationship of individual and supportive dyadic/common coping to emotional well-being and relationship satisfaction. Participants were 92 women recently diagnosed with cancer (mostly breast cancer) and receiving medical treatment ( Mage = 49.37 years; SD = 10.52). All had been living with their partner for at least 2 years. The parallel use of individual and supportive dyadic/common coping behaviors was frequently reported. Individual and dyadic/common coping proved to be related to each other ( p < .01), and both were related to emotional well-being and relationship satisfaction ( p < .05). The combination of high individual and high supportive dyadic/common coping was associated with greater satisfaction with the relationship ( p < .01). Patients probably use individual and dyadic coping behaviors in concert to better deal with the different aspects of their illness experience. Both types of coping should be considered in the context of personalized intervention programs to facilitate adaptation to cancer.

How Family-Work Conflict Influences Post-traumatic Growth Among Medical Workers: A Moderated Mediation Model

Under the impact of COVID-19, the status and mechanisms of post-traumatic growth among medical workers facing challenges related to family-work conflict are of great concern. In view of the complex relationship between family-work conflict and post-traumatic growth, the present study sought to explore the specific relationships between family-work conflict and post-traumatic growth as well as the specific roles of positive psychological capital, perceived social support, and suppression. We recruited 1,347 participants. The results revealed that positive psychological capital and perceived social support played mediating roles, while suppression strategies moderated the mediating effect. Compared with the low suppression group, the negative impact of family-work conflict on positive psychological capital and perceived social support was reduced in the high suppression group. Thus, a higher level of suppression was more conducive to post-traumatic growth. The current study enriches and expands the findings of previous studies in theory and provides practical ways to promote post-traumatic growth in medical workers.

Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time?

Despite an enormous number of studies addressing the importance of posttraumatic growth (PTG) among cancer patients, the literature lacks data regarding how different coping strategies affect PTG among head and neck cancer (HNC) patients over time. This longitudinal study investigated the PTG trend and coping over 5-7months among a cohort of HNC patients within the first year after their diagnosis. It determined an association between coping strategies and PTG over time. The study's HNC respondents were administered a socio-demographic and clinical characteristics questionnaire during their baseline assessments. Additionally, the Malay versions of the "PTG Inventory-Short Form" (PTGI-SF) and the "Brief Coping Orientation to Problems Experienced Inventory" (Brief COPE) were administered during respondents' baseline assessments and follow-up assessments (5-7months after the baseline assessments). In total, 200 respondents reported an increasing PTG trend and approach coping (active coping, planning, positive reframing, acceptance, emotional support, and instrumental support) and a decreasing trend of avoidant coping (self-distraction and denial) over time. Two approach coping strategies (acceptance and planning) significantly increased PTG while denial was the only avoidant coping strategy that significantly lowered PTG, after controlling for socio-demographic and clinical characteristics, over time. Our study's findings identified the need to incorporate psychosocial interventions that enhance approach coping and reduce avoidant coping into HNC patients' treatment regimes.

Status and factors related to post-traumatic growth in continuous ambulatory peritoneal dialysis: A multi-centre study

Aim

To investigate the extent of post‐traumatic growth, and the correlation between post‐traumatic growth and self‐perceived stress, post‐traumatic growth and self‐perceived burden among CAPD patients.

Design

A cross‐sectional study.

Methods

This was a multi‐centre study including 752 patients from 44 hospitals. Self‐perceived stress, self‐perceived burden and post‐traumatic growth were measured using the post‐traumatic growth inventory (PTGI), the Chinese version of the perceived stress questionnaire (CPSQ) and the self‐perceived burden scale (SPBS). A multiple stepwise regression analysis was fit with the total PTGI score as the outcome of interest.

Results

Patients concurrently experienced post‐traumatic growth and stress following peritoneal dialysis. The initiation of patients’ education level, employment status and self‐perceived stress were all found to relate to growth among Chinese CAPD patients. There was not sufficient evidence to suggest that self‐perceived burden was related to experiencing growth.

Meaning Making for Psychological Adjustment and Quality of Life in Older Long-Term Breast Cancer Survivors

Objectives: This study aims to explore in depth the meaning and meaning discrepancies among older Norwegian breast cancer survivors in light of the meaning making model by Park (2013).

Design: We utilized a qualitative design collecting data using semi-structured interviews of 23 elderly breast cancer survivors 7–8 years after treatment. The interviews followed an interview guide structured along three main themes: “everyday life activities,” “follow-up-care experiences” and “health status and QoL.”

Results: Several health problems were reported by the women in the aftermaths of the disease, such as sleeping problems, pain, and fatigue—including cognitive and emotional impairments. Meaning discrepancies were concentrated on six main themes: shifting perspectives and priorities, growing sense of autonomy, widening the limits of normality, dissociating oneself from the disease, embracing alternative health services, and feeling lucky. The women engaged in a wide range of coping techniques as efforts to change global meaning, and to develop a more positive view on the cancer experience. Common coping efforts across the six main themes were social comparison, denial, positive reappraisal, problem-focused coping, and revaluing ordinary events.

Conclusion: Many cancer patients report on unmet needs for help with their meaning making, and the facilitation of meaning making processes is rarely included in the follow-up care of cancer survivors. The findings of the present study may help health care professionals provide care for women who have experienced breast cancer. The concrete knowledge of common coping efforts in the meaning making process may contribute to the development of future interventions and for gaining a deeper understanding for older survivors of breast cancer.

A longitudinal investigation of posttraumatic growth and its associated factors among head and neck cancer survivors

OBJECTIVES

Posttraumatic growth (PTG) may improve well-being among cancer survivors, but a longitudinal study addressing head and neck cancer (HNC) is lacking. This longitudinal study examined PTG trends and determined the associations of physical symptoms and complications, as well as sociodemographic and tumor characteristics on PTG over time among HNC survivors.

METHODS

Participants completed the European Organization of Research and Treatment of Cancer's "Quality of Life Questionnaire-Head and Neck 35" module (EORTC-QLQ-H&N-35) and "Posttraumatic Growth Inventory-Short Form" (PTGI-SF) during baseline (T₁ ) and follow-up (T₂ ; 5-7 months post-baseline) assessments.

RESULTS

In total, 200 HNC participants completed the study and 67.5% of them reported increasing PTG. Physical symptoms and complications that were significantly associated with lower PTG included problems with social contact and the senses. Meanwhile, sociodemographic variables that were significantly associated with PTG were gender (males had lower PTG than females) and religion (Muslims and Buddhists had higher PTG than participants of other religious faith).

CONCLUSION

Our findings revealed the need to focus on the impact of sensory issues and reduced social contact following HNC on PTG which may be addressed by various restorative and supportive rehabilitation therapy.

Perceived Positive and Negative Life Changes in Testicular Cancer Survivors

Background and objectives: Despite a generally good prognosis, testicular cancer can be a life-altering event. We explored perceived positive and negative life changes after testicular cancer in terms of frequency, demographic and disease-related predictors, and associations with depression and anxiety. Materials and methods: All testicular cancer survivors receiving follow-up care at two specialized outpatient treatment facilities were approached at follow-up visits or via mail. We assessed a total of N = 164 patients (66% participation rate, mean time since diagnosis: 11.6 years, SD = 7.4) by the Posttraumatic Growth Inventory (PTGI, modified version assessing positive and negative changes for each of 21 items), Patient-Health-Questionnaire-9 (PHQ-9), and Generalized-Anxiety-Disorder-Scale-7 (GAD-7). We conducted controlled multivariate regression analyses. Results: Most survivors (87%) reported at least one positive change (mean number: 7.2, SD = 5.0, possible range: 0-21). The most frequent perceived positive changes were greater appreciation of life (62%), changed priorities in life (62%), and ability rely on others (51%). At least one negative change was perceived by 33% (mean number of changes: 1.1, SD = 2.5). Negative changes were most frequent for decreases in self-reliance (14%), personal strength (11%), and ability to express emotions (9%). A higher socioeconomic status was associated with more positive changes (β = 0.25, 95% CI 0.08 to 0.42); no other association with demographic and disease-related predictors emerged. While positive life changes were not associated with depression (β = -0.05, 95% CI -0.17 to 0.07) and anxiety (β = 0.00, 95% CI -0.13 to 0.13), more negative life changes were significantly associated with higher depression (β = 0.15, 95% CI -0.03 to 0.27) and anxiety (β = 0.23, 95% CI 0.11 to 0.36). There was no significant interaction of positive and negative changes on depression or anxiety. Conclusions: Although positive life changes after testicular cancer are common, a significant number of survivors perceive negative changes in life domains that have been primarily investigated in terms of personal growth. Early identification of and psychosocial support for patients who perceive predominantly negative changes may contribute to prevention of prolonged symptoms of anxiety and depression.

Concordance of Child Self-Reported and Parent Proxy-Reported Posttraumatic Growth in Childhood Cancer Survivors

Simple Summary

In pediatric cancer settings, parents can be asked to provide information about the impact of cancer on the child. However, their assessment of the child may not be accurate. Research has shown that parents tend to underestimate the quality of life of their child following pediatric cancer. Little is known about the accuracy of parental reports of posttraumatic growth (PTG) as a consequence of pediatric cancer. Our study aimed to examine concordance of parent- and child-reported PTG with taking into account the parents’ own level of PTG. We found poor parent–child concordance, with parents reporting higher levels of PTG for their children than the children themselves. When assessing their child’s PTG, parents are influenced by their own level of PTG. These findings provide implications for the research on psychosocial outcomes of pediatric cancer using a multi-informant perspective as well as for the topic of veracity of PTG in general.

Abstract

This article aimed to analyze concordance of parent- and child-reported child posttraumatic growth (PTG) following pediatric cancer, the influence of the parents’ own level of PTG on the level of concordance and the influence of the parents’ and the child’s own level of PTG on the parents’ proxy reports of PTG in the child. The sample included 127 parent–child dyads. The children provided self-reports of PTG and the parents provided reports of their own as well as the child’s PTG. Overall, the results showed poor parent–child agreement on the child PTG, with the parents proxy-reporting higher levels of PTG than the children. The parents’ proxy reports of the child PTG were the most accurate at the lowest levels of the parents’ own level of PTG. The parents’ own level of PTG was a stronger predictor of the parents’ proxy reports than the child self-reported PTG. The results suggest that parents are not very accurate reporters of PTG in the child; therefore, their reports should be completed with child self-reports whenever possible.

Stress-Related Growth Scale-Short Form: A Portuguese validation for cancer patients

Abstract Background/Objective

Cancer can be extremely disruptive, triggering high levels of distress, and at the same time transformative, promoting perceptions of positive life changes and growth. This study aims to analyze the psychometric proprieties of the Stress-Related Growth Scale Short-Form (SRGS-SF) in cancer patients.

Method

209 Cancer patients heterogeneous in disease stage and diagnosis completed: clinical and sociodemographic information, Distress Thermometer, Positive and Negative Affect Schedule, Visual-analogue Scale of Perceived Positive Life Changes, and Stress-Related Growth Scale-Short Form.

Results

The analysis of internal structure pointed to an one-dimensional scale, with high reliability (.92) measured through the McDonald`s omega coefficient. Validity was also evidenced through significant correlations with other variables.

Conclusions

The Portuguese version of the SRGS-SF seems to present the necessary psychometric proprieties to be considered a valid and reliable short tool, to assess perceptions of growth following cancer and contribute to targeted and integrative psycho-oncological interventions.

Combined quality of life and posttraumatic growth evaluation during follow-up care of patients suffering from oral squamous cell carcinoma

Oral cancer therapy is associated with a loss in health-related quality of life (HRQOL) and can also lead to post-traumatic growth (PTG). The current study analyzed the relationship between HRQOL, PTG and influencing clinical factors after treatment. The coherent clinical data of 15 patients were retrospectively analyzed over a 1-year study period. HRQOL and PTG were studied using the University of Washington Quality of Life Version 4 (UW-QOL v4) and Posttraumatic Growth Inventory (PTGI) questionnaires. The results revealed that HRQOL was significantly decreased in a pre- to postoperative manner (P=0.011). Sex demonstrated a nearly significant effect on HRQOL (P=0.058). PTG was experienced the most after surgery, and continuously decreased over the 1-year study period. Patient age had a significant effect on PTG (P=0.040). A significant correlation was also established between HRQOL and PTG (P<0.05). HRQOL and PTG are important influencing factors during postoperative tumor follow-up care and should be simultaneously recorded to address individual patient needs and improve quality of treatment.

Relationship between infertility-related stress and resilience with posttraumatic growth in infertile couples: gender differences and dyadic interaction

STUDY QUESTION

Are there any gender differences and dyadic interactions in the associations between infertility-related stress and resilience and posttraumatic growth in infertile couples?

SUMMARY ANSWER

Husbands' posttraumatic growth was only impacted by their own infertility-related stress and resilience, whereas wives' posttraumatic growth was influenced by their own resilience and their spouses' resilience.

WHAT IS KNOWN ALREADY

Posttraumatic growth may play a significant role in protecting the infertile couples' psychological well-being and contribute to positive pregnancy outcomes. The reciprocal influence on each other within the infertile couple in terms of relationships between infertility-related stress and resilience and posttraumatic growth has been largely overlooked.

STUDY DESIGN, SIZE, DURATION

This cross-sectional study included 170 couples who were recruited from the First Affiliated Hospital of Soochow University between September 2019 and January 2020.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The Fertility Problem Inventory, Connor-Davidson Resilience Scale-10, and Post-traumatic Growth Inventory were used to measure infertility-related stress, resilience, and posttraumatic growth. The Actor-Partner Interdependence Model was used to analyze the effects of infertility-related stress and resilience on the couple's own posttraumatic growth (actor effect) as well as on their partner's posttraumatic growth (partner effect).

MAIN RESULTS AND THE ROLE OF CHANCE

Husbands had higher levels of resilience than wives, while no significant gender differences were found in the levels of infertility-related stress and posttraumatic growth. Posttraumatic growth correlated with each other among infertile couples. Husbands' infertility-related stress had actor effects on their own posttraumatic growth, while wives' infertility-related stress had no effect on their own or their spouses' posttraumatic growth. Husbands' resilience had actor and partner effects on their own and their wives' posttraumatic growth, while wives' resilience only had an actor effect on their own posttraumatic growth.

LIMITATIONS, REASONS FOR CAUTION

First, our sample was limited to infertile Chinese couples seeking clinical treatment. Second, sociodemographic and psychological measures were self-reported. Third, as the current study is a cross-sectional study, the dynamic process of posttraumatic growth is unknown.

WIDER IMPLICATIONS OF THE FINDINGS

Infertile couples should be considered as a whole in studies on infertility. Couple-based psychological interventions are critical and more effective in improving mental health among individuals with infertility. Elevating the level of resilience may contribute to improving posttraumatic growth for both husbands and wives. Moreover, enhancing the ability to cope with infertility-related stress might be useful for husbands and indirectly contribute to wives' posttraumatic growth.

STUDY FUNDING/COMPETING INTEREST(S)

This research was supported by the National Natural Science Foundation of China (Grant No. 31900783) and the College Natural Science Research Project of Jiangsu Province (Grant No.19KJD320004). The authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER

N/A.

Prevalence of benefit finding and posttraumatic growth in long-term cancer survivors: results from a multi-regional population-based survey in Germany

Background

Cancer studies reported mixed results on benefit finding (BF) and posttraumatic growth (PTG) prevalence and few were focused on long-term survivors.

Methods

BF and PTG were assessed in a multi-regional population-based study in Germany with 6952 breast, colorectal and prostate cancer survivors, using the Benefit Finding Scale and Posttraumatic Growth Inventory. We calculated the age-adjusted prevalence, stratified by demographical and clinical characteristics.

Results

Overall, 66.0% of cancer survivors indicated moderate-to-high BF, and 20.5% moderate-to-high PTG. Age-adjusted prevalence of BF and PTG differed according to cancer type (breast > colorectal > prostate) and sex (female > male). BF and PTG prevalence were higher in younger than in older respondents; the age-adjusted prevalence was higher in respondents who survived more years after diagnosis. The strength and direction of associations of age-adjusted prevalence with cancer stage, disease recurrence, and time since diagnosis varied according to cancer type and sex.

Conclusions

A substantial proportion of long-term cancer survivors reported moderate-to-high BF and PTG. However, the prevalence was lower in older and male cancer survivors, and during the earlier years after cancer diagnosis. Further longitudinal studies on PTG and BF in cancer survivors are warranted to address heterogeneity in survivors’ experience after cancer diagnosis.

Correlates of Post-traumatic Growth Following a Myocardial Infarction: A Systematic Review

Correlates of post-traumatic growth (PTG) have been examined in the area of health psychology previously, with much focus on aspects of personality, coping, and social support. This systematic review aimed to examine correlates of PTG for those who have experienced a myocardial infarction (MI). Studies which met inclusion criteria were assessed for quality and reviewed. Results showed an inconsistent strength of associations between studies and so conclusions cannot be drawn. Possible reasons for these differences are discussed and recommendations for future research are suggested.

Post-Traumatic Growth Experiences among COVID-19 Confirmed Cases in China: A Qualitative Study

COVID-19 infection can cause psychological distress and profoundly impact patients' lives, but it can also lead to positive changes and post-traumatic growth (PTG), or positive psychological change in response to challenging life circumstances. Current research on the influence of COVID-19 infection has mainly focused on its negative effects. Therefore, the aim of this study was to investigate whether patients with COVID-19 in China experienced PTG and, if so, what changed for them during the process of PTG. We used a qualitative descriptive approach to conduct this study. Using the purposive sampling recruitment method, patients with a confirmed COVID-19 diagnosis were recruited from a COVID-19 designated hospital in Shanghai, China, from April to July 2020. Data were collected using semi-structured, in-depth interviews conducted via cell phone or in person while social distancing to prevent the spread of COVID-19. Forty confirmed COVID-19 patients (19-68 years old) were recruited. Several prominent themes and subthemes were extracted from the interview responses regarding participants' experiences of PTG. The following are among the positive changesthat occurred for these participants after their diagnosis of COVID-19: (1) Reevaluation of their life priorities, which included a greater appreciation of being alive and re-evaluating their values and goals, (2) Improved relationships within their social circles, which included establishing or maintaining closer relationships with family and friends and a greater willingness to help others, and (3) Perceived changes regarding themselves, which included personal growth and increased awareness of the importance of their health. The study identified potential positive impacts of COVID-19 on patients, which could be helpful in the implementation of interventions to facilitate PTG among COVID-19 survivors.

Post-traumatic growth after cancer: a scoping review of qualitative research

Purpose

Interest is growing in post-traumatic growth (PTG) after cancer prompted, in part, by observations of positive associations with health-related quality of life. Qualitative research provides valuable insight into survivors’ experiences. We conducted a scoping review of qualitative evidence on PTG in cancer, determining the number, nature, range and scope of studies, and gaps in the literature.

Methods

We systematically searched Medline, Scopus, CINAHL, Web of Science, and PsycINFO for qualitative research exploring positive changes after cancer published from 1996. From eligible studies, we extracted: terms used for PTG; design, methodological orientation, and techniques, and participant characteristics. Using descriptive mapping, we explored whether study findings fit within Tedeschi and Calhoun’s PTG framework, and evidence for unique positive changes post-cancer.

Results

Twenty-eight studies were eligible. Cancer sites included were: breast, 14; mixed, 6; haematological, 4; head and neck cancer, 2; bone, 1, and testis, 1. Multiple studies were conducted in: the USA (12), Australia (3), Iran (2), and the UK (2). Twenty-three studies collected data using individual interviews (21) or focus groups (2). Definitions of PTG varied. Studies largely focused on descriptive accounts of PTG. Findings mapped onto existing PTG dimensions; health behaviour changes were often reported, under ‘new possibilities’.

Conclusions

A range of PTG outcomes can occur after cancer. Positive health behaviour changes warrant further exploration. Future research should include more diverse patient populations, collect longitudinal data, and focus on pathways towards positive changes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-021-06253-2.

Understanding benefit finding among patients with colorectal cancer: a longitudinal study

PURPOSE

Perceiving positive life changes ("benefit finding") is thought to promote better adjustment after cancer, yet is poorly understood among colorectal cancer (CRC) patients. We characterized benefit finding and examined its relationship to demographic/medical factors, change over time, and association with distress.

METHODS

CRC outpatients (N = 133, 50% metastatic) completed self-report measures (demographic/medical factors, benefit finding, distress) at baseline and 6 months later. Wilcoxon rank-sum (Kruskal-Wallis) tests or Spearman correlations tested associations between benefit finding and demographic/medical factors. Linear regressions assessed (1) change in benefit finding over time and whether this differed by demographic/medical factors, and (2) association between benefit finding and distress and whether this changed over time.

RESULTS

Benefit finding was common among patients with CRC, with highest rated items reflecting gratitude, acceptance, and stronger family relationships. Women and racial minorities reported greater benefit finding than men (p < 0.001) and White patients (p = 0.015), respectively. Medical factors (e.g., metastatic disease) were not associated with benefit finding. Benefit finding significantly increased over time (p = 0.03). While greater benefit finding trended towards an association with lower distress, results were not statistically significant and the relationship did not change over time.

CONCLUSION

Benefit finding was characterized largely by perceived psychological and social benefits, as opposed to pragmatic benefits. Individual differences and social determinants may be more informative than medical characteristics when it comes to benefit finding; although, cultural factors and mediators should be examined further. Benefit finding seems to evolve over time perhaps as a coping process; however, its association with psychological distress appears tenuous.

Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol

INTRODUCTION

Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period.

METHODS AND ANALYSIS

This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I-IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients' characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time.

ETHICS AND DISSEMINATION

The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal.

Post-Traumatic Growth and Stress-Related Responses During the COVID-19 Pandemic in a National Representative Sample: The Role of Positive Core Beliefs About the World and Others

Given the need to understand both the negative and positive psychological consequences of the current global COVID-19 pandemic (Brewin et al. in Perspectives in Public Health 10.1177/1757913920957365 2020), the aim of this study was to test a cognitive model of post-traumatic symptoms (PTS) and post-traumatic growth (PTG) during confinement caused by the SARS-COV-2 epidemic. In line with cognitive models of trauma elaboration (Park in Psychological Bulletin 10.1037/a0018301), we included in our model some beliefs associated to the world (e.g., primal beliefs about a good world), to the self (e.g., death anxiety or orientation toward the future) and to others (e.g., suspiciousness or identification with humanity). To evaluate the explanatory model, a national representative sample of adults between the ages of 18 and 75 (N = 1951) was surveyed between 7th and 13th April, 2020, in the middle of a strict 7-week national confinement. Structural equation modelling yielded a very similar model to the one initially specified. The results highlight the role of both negative and positive core beliefs, which are pertinent to the current pandemic threat, in the appearance of PTS and PTG, respectively. In short, primal beliefs about a good world, openness to the future and identification with humanity were associated with PTG; while suspiciousness, intolerance of uncertainty, anxiety about death and also identification with humanity were associated with PTS and consequent impairment. This is an innovative study of different pathways to traumatic responses and growth during a pandemic. Future research is needed to replicate its findings.

The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: A systematic review

BACKGROUND

Studies have reported mixed findings on the relationship between posttraumatic growth (PTG) and health-related quality of life (HRQOL) in cancer survivors. This review aims to give an overview of these studies and to identify potential study- and sample-level factors that could contribute to the heterogeneity of those findings on the relationship between PTG and HRQOL in cancer survivors.

METHODS

Multiple electronic databases were systematically searched using the concepts 'posttraumatic growth', 'cancer', and 'health-related quality of life'. Eligible studies (published until 2018) were reviewed, quality-assessed, and effect sizes were extracted and synthesized.

RESULTS

Of the 37 included articles, 22 received a rating of 'weak', 11 'moderate' and 4 'strong' in study quality assessment. The overall sample comprised 7954 individuals, mean age of 55.30 years, >50% females, predominantly breast cancer, and survivors mainly within 5 years post-diagnosis. The synthesized results revealed a positive association between PTG and HRQOL (Fisher's z= 0.16) on a total scale, with significant high heterogeneity (I²=75%). Variations in HRQOL measurement and methodological inconsistency contributed to study-level differences of effect sizes. Sample-level characteristics such as geographic region, smaller sample sizes (n < 100) and so on contributed to heterogeneity.

LIMITATIONS

Studies assessing the relationship between PTG and HRQOL were heterogeneous, of weak study quality generally, and results were difficult to combine.

CONCLUSIONS

Most studies found a positive relationship between the factors suggesting that PTG may play a role for successful coping following cancer. However, studies of higher quality and longitudinal design are needed.

Resilience in women with breast cancer: A systematic review

PURPOSE

Resilience refers to a dynamic process that promotes a successful adaptation to cancer-related adversity. The aim of this systematic review was to identify the biopsychosocial factors involved in the resilience of women with breast cancer and to integrate evidence on the interventions that can contribute to significantly enhancing it.

METHOD

Three databases were searched. In all, 923 articles were identified and, of these, 39 peer-reviewed articles were included.

RESULTS

Resilience was associated with multiple clinical, sociodemographic, social, psychological and physiological variables, with psychological factors being the most important contributors to the development of resilience. Some protective factors were identified, such as social support, several dimensions of quality of life (QOL) and adaptive coping strategies. Psychological distress was the variable most frequently linked to reductions in resilience, finding a bidirectional relationship between them. Resilience-promoting interventions were found to be effective in improving participants' psychological well-being.

CONCLUSION

Resilience is a relevant factor related with several sociodemographic, clinical, psychosocial and physiological variables in women with breast cancer. However, limitations such as the wide variability of instruments used together with the heterogeneity and small size of the samples restrict the generalizability of our conclusions.

Exploring narratives on PTG in cancer patients in active vs remission phases of disease: what about a peritraumatic growth?

OBJECTIVE

The present study aims to explore post-traumatic growth in cancer patients comparing the active phase, when patients undergo different treatments, and the remission phase, characterised by periodic follow-ups and gradually return to lives outside the hospital world.

METHODS

69 cancer patients (36 in active phase and 33 in remission phase) completed an online survey narrating their growth experience related to cancer disease. A modelling emergent theme analysis was implemented for narratives of both group by means of T-Lab software.

RESULTS

Four themes emerged for narratives of active phase group: 'the time of illness and the time of life (saturating the 46% of words)', 'the meaning-seeking' (21%), 'to find oneself in a battle (21%)' and 'to learn by battling' (12%). Remission phase group themes concerned 'the time of life' (40%), 'the seismic experience' (31%), 'to care for the Self and for others' (15%) and 'strength from vulnerability' (14%).

CONCLUSIONS

Remission group narratives are close to PTG as defined in scientific literature, while patients in the active phase of disease narrated PTG as the attempt of including illness in their life trajectory and learning from the battle against cancer. Author suggests the definition of peritraumatic growth as a transformation process parallel to treatment phase.

Health-related quality of life measured using EQ-5D in patients with lymphomas

PURPOSE

This study aimed to estimate the health preference-based index scores of the population of patients with lymphoma using the EQ-5D in China.

METHODS

A cross-sectional online survey was conducted to examine the health and well-being of patients with lymphoma in China. Their health-related quality of life (HRQoL; using the EQ-5D), demographic and socioeconomic characteristics, and health conditions were assessed. The data were analyzed using Pearson's χ² test, analysis of variance, and binary logistic and Tobit regression models.

RESULTS

A total of 3261 patients (sex: men = 58.5%, age: < 30 years = 9.5% and > 60 years = 24.6%) participated in the study. The mean EQ-5D-5L index and EQ-VAS scores were 0.83 and 68.8, respectively. Binary logistic regression analysis revealed that women reported more pain-related problems than men did. Unemployed participants were substantially more likely to report health problems on all the five dimensions of the EQ-5D than their employed counterparts. The Tobit regression model revealed that respondents who were older, unemployed, with low income, received chemotherapy, and with short durations reported a low index score.

CONCLUSION

Using the EQ-5D, the preference-based scores of different subpopulations of patients with lymphoma may support economic evaluation by promoting the simultaneous consideration of both the reasonable use of resources and satisfactory achievement of health outcomes.

A prospective study of cancer-related benefit finding in uveal melanoma patients

Little is known about contributors to the psychosocial impact of uveal melanoma, a rare cancer. Predictors and outcomes of benefit finding, a potentially favorable outcome, were investigated. Adults (n = 107) completed assessments prior to diagnosis of uveal melanoma and one week, three months and 12 months after diagnosis. Path analyses with the full information maximum likelihood estimation method were conducted. Objective disease impact on vision did not predict benefit finding (p > .05). Approach-oriented coping prior to diagnosis and one week later significantly predicted greater benefit finding 12 months later (p < .01). Avoidance-oriented coping at three months moderated the concurrent relationship of benefit finding and positive affect at 12 months (p < .001). This first study of predictors of benefit finding in uveal melanoma patients suggests that greater approach-oriented coping prospectively predicts higher benefit finding. Further, avoidance may condition the association of benefit finding with psychosocial outcomes.

[Post-traumatic growth: Some conceptual considerations]

OBJECTIVE

Post-traumatic growth (PTG) is a quite new concept of positive psychology proposed in the mid-1990s which is still rather confidential in France. This article aims to propose a full description of this concept from an historical view to epidemiological data through underlying mechanisms and evaluation.

METHODS

A literature search identifying relevant results was performed through the Pubmed database.

RESULTS

PTG refers to positive psychological changes experienced as a result of a traumatic life event in order to rise to a higher level of functioning. That is to say that people experiencing psychological struggle following adversity may often see positive outcomes in the aftermath of trauma. Domains of PTG include appreciation of life, relationships with others, new possibilities in life, personal strength and spiritual change. A self-report scale, the Post-Traumatic Growth Inventory (PTGI), has been developed. PTG has been demonstrated after various traumatic events such as transport accidents, natural disasters, interpersonal violence or medical problems, with a prevalence ranging from 3 to 98 % depending on the type of trauma.

DISCUSSION

The concept of resilience and some evaluation bias may have been deleterious for the development of the PTG concept in the French-speaking world. There is a need to consolidate data to understand the pathway leading to PTG, noticeably to identify factors contributing to PTG that can help to promote the growth as a new therapy for trauma.

Measuring positive psychosocial sequelae in patients with advanced cancer

OBJECTIVE

Posttraumatic growth and benefit finding describe the potential for positive changes resulting from traumatic experiences, including cancer. In oncology, these constructs are increasingly examined concurrently using the Posttraumatic Growth Inventory (PTGI) and the Benefit Finding Scale (BFS). However, distinctions between these constructs and their corresponding scales are not altogether clear, and the burden of administering 2 lengthy questionnaires is evident, particularly for patients at end-of-life.

METHOD

Baseline data from 209 participants enrolled in a randomized controlled trial evaluating the efficacy of a psychosocial intervention were analyzed. We assessed the structure and covariance of all PTGI and BFS items using item response theory to determine the extent to which these measures overlap and the potential value of their concurrent administration in patients with advanced cancer.

RESULTS

Despite conceptual differences in posttraumatic growth and benefit finding, results indicated that these measures address the same underlying construct. We subsequently analyzed 3 abbreviated scales (7, 11, and 16 items) that combine items from both scales to identify an optimal briefer combined scale. Results supported all 3 versions, with the 7- and 16-item measures appearing to have the best balance of content and concurrent validity and the 11-item version optimizing information gained with brevity.

CONCLUSIONS

These findings indicate that concurrent administration of the PTGI and BFS may be unnecessary given the high degree of overlap between these 2 measures and that a brief subset of items may adequately evaluate positive change among patients with advanced cancer while reducing participant burden. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An Integrative Framework of Appraisal and Adaptation in Serious Medical Illness

Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care's focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients' use of active (vs. passive) and approach-oriented (vs. avoidant) coping strategies. However, without a framework outlining the process that individuals with serious medical illness and their loved ones undergo, it is challenging to discern exactly where, how, and why palliative care may affect the serious medical illness experience. To address this gap, we propose a clinically applicable framework, derived from existing theory and research in the social and behavioral sciences. This framework, called the Integrative Framework of Appraisal and Adaptation in Serious Medical Illness, describes how patients and their loved ones cognitively and emotionally process the various events that may occur as they navigate serious medical illness and the end of life. The framework also describes how individuals and their loved ones use that event processing to determine next steps, while considering the impact of their surrounding external environment, their individual social roles, and their connections on this decision making. The framework presented in this article is intended to improve our ability to understand and care for individuals with serious medical illness and their loved ones, while stimulating further discussion and research to test and refine these ideas.

The factor structure of the posttraumatic growth inventory in cancer patients in Turkey

Posttraumatic growth is a positive psychological change that occurs as a result of tackling vital crises. Although cancer is perceived as a fatal disease, the individual's struggle with many negative conditions during diagnosis and treatment can provide positive change and development. The aim of this study was to examine the factor structure of the posttraumatic growth inventory (PTGI) in Turkish cancer patients. This study included 265 cancer patients receiving treatment at the chemotherapy unit of two university hospitals located in northern Turkey. Percentages, frequencies, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyse the data, and Cronbach's α measured internal consistency. EFA yielded a five-factor structure: Spiritual and existential change, change in perception of life and selfness, relating to others, personal strength and new possibilities. Fit indices for CFA were root mean square error of approximation (RMSEA), 0.06; non-normed fit index (NNFI), 0.92; comparative fit index (CFI), 0.90; root mean residuals (RMR), 0.06; and goodness-of-fit index (GFI), 0.90. The overall Cronbach's α of the scale was 0.93. PTGI was determined as a reliable and valid tool for Turkish cancer patients. PTGI, which has a determined validity and reliability rate, can be used by healthcare professionals working with oncology patients to evaluate the positive psychological growth and changes in cancer patients and determine their adoption rate.

Profiles of resources and posttraumatic growth among cancer and psoriatic patients compared to non-clinical sample

BACKGROUND/OBJECTIVE

The aims of this study were to explore the heterogeneity of resources, as described by the Conservation of Resources (COR) theory, in a sample of cancer and psoriatic patients and to investigate whether heterogeneity within resources explains differences in Posttraumatic Growth (PTG) level within each of these clinical samples and in a non-clinical control group.

METHOD

The sample consisted of 925 participants, including 190 adults with a clinical diagnosis of gastrointestinal cancer, 355 adults with a medical diagnosis of psoriasis, and 380 non-clinical (without any chronic illnesses) adults, all of whom had suffered various adverse and traumatic events. The participants completed a COR evaluation questionnaire and a posttraumatic growth inventory.

RESULTS

A latent profile analysis revealed four different classes of psoriatic patients and five classes of cancer patients, all with different resources levels. Clinical subsamples differed substantially with PTG levels compared to healthy controls.

CONCLUSIONS

Our study did not find a sole pattern of PTG that fit all the individuals, even for those who experienced the same type of traumatic event. Psychological counseling, in chronic illness particularly, should focus on the heterogenetic profiles of patients with different psychosocial characteristics.

Effectiveness of psychosocial interventions for posttraumatic growth in patients with cancer: A meta-analysis of randomized controlled trials

PURPOSE

To evaluate the effectiveness of psychosocial interventions for posttraumatic growth in patients with cancer.

METHOD

A systematic literature search was performed, and relevant studies published prior to January 8, 2020, were retrieved from MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trails, CINAHL, and PsycINFO. Two reviewers independently assessed the eligibility of each study and extracted the data. The Cochrane risk-of-bias tool was utilized to assess the quality of the studies. Review Manager (Version 5.3) was used to analyse the data. The posttraumatic growth scores were calculated using the standard mean difference (SMD) and 95% confidence intervals (CIs).

RESULTS

Fifteen randomized controlled trials published between 2000 and 2019 were included. Most of the studies had a moderate risk of bias due to low methodological quality. The meta-analysis indicated that the PTG scores in the experimental groups were higher than those in the control groups (SMD = 0.42, 95% CI: 0.26-0.57, P < 0.00001). The most effective and commonly used method was mindfulness-based interventions (SMD = 0.55, 95% CI: 0.15-0.95, P = 0.007). Subgroup analysis showed that the effects of psychosocial interventions on breast cancer patients are greater than the effects on other types of cancer patients (SMD = 0.72, 95% CI: 0.44-0.99, P < 0.00001).

CONCLUSION

Psychosocial interventions for cancer patients are effective in facilitating posttraumatic growth. The most commonly used and effective methods are mindfulness-based interventions. More large well-designed randomized controlled trials are needed to identify the effectiveness of psychosocial interventions for posttraumatic growth in patients with cancer.

What are the psychological effects of mesothelioma on patients and their carers? A scoping review

OBJECTIVE

Despite recent advances in research, malignant mesothelioma remains an incurable and devastating disease, typically bringing shock and emotional distress to patients and carers. Little research has addressed the psychological impact on either group. This scoping review examines the current state of evidence on the psychological effects of mesothelioma on patients and carers, and identifies areas for further research.

METHODS

We searched PubMed, PsychINFO, CINAHL, the Cochrane Library and Web of Science for English-language peer-reviewed research articles published 1981 to 2019 reporting studies focussing on the psychological effects of mesothelioma on patients and carers. Following data extraction and quality appraisal, reflexive thematic analysis was used to identify themes.

RESULTS

Seventeen articles met the inclusion criteria. Carers' experiences were generally amalgamated with patients'. Three themes were developed. The Passing of Time included the importance of timing of interventions; delays in the medical journey; awareness of different time-phases in mesothelioma; and uncertainty/certainty. Dealing with Difficult Feelings reflected ubiquitous negative emotions, feelings about identity and states of being and associated coping strategies. Craving Good Communication covered issues related to sharing of information and to positive/negative aspects of communication.

CONCLUSIONS

Though limited, the evidence indicates that mesothelioma, with its high symptom-burden, incurability, rarity and asbestos-related causation, leads to complex and inter-relating psychological effects on patients and carers. These effects are both negative and positive. The sparse literature gives a partial picture and demonstrates an urgent need for more nuanced research. Studies exploring the experiences of specific groups are recommended, with particular attention required to carers.

Post-traumatic growth among gastrointestinal oncological patients: the perspective of Stevan Hobfoll’s conservation of resources theory

Background

This study assessed the relation between social support dimensions and post-traumatic growth (PTG) among a sample of gas-trointestinal cancer patients. Particular focus was placed on the mediating role of resources based on the conservation of re-sources (COR) theory and its effect on the previously mentioned association.

Participants and procedure

A total of 190 patients comprising 87 females and 103 males with a clinical diagnosis of gastrointestinal cancer were recruited to participate in this study. This was a cross-sectional study, with social support evaluated by the Berlin Social Support Scales (BSSS). The participants’ levels of subjectively possessed resources were assessed by the Conservation of Resources Evalua-tion (COR-E) questionnaire. Posttraumatic growth was evaluated by the Post-Traumatic Growth Inventory (PTGI).

Results

No direct relation was found between social support and PTG among participants. However, a mediating role of subjectively possessed resources was detected through the COR theory on the aforementioned relationship, i.e. the link between social sup-port and PTG. More specifically, the level of economic and political resources was a mediator in the relation.

Conclusions

These results contribute to extant literature on the psychological aspects of gastrointestinal cancer. Evidently, social support may be related to positive outcomes among gastrointestinal cancer patients in the form of PTG.

Assessment of the Level of Pain Intensity and the Level of Anxiety Treated as State and Trait in Patients with Osteoarthritis of the Limbs

Introduction

Osteoarthritis of the musculoskeletal system is accompanied with chronic pain which is the main factor in mood lowering, causing anxiety. Rehabilitation conducted in the framework of spa therapy and outpatient care aims at eliminating or reducing pain and improving physical fitness. Pain relief is an expected phenomenon because it improves the quality of life. Aim of the study. The aim of the study was to evaluate the effect of rehabilitation in the spa and in outpatient clinic on the level of pain and anxiety in patients with degenerative joints and disc disease. Material and methods. The study included a comprehensive treatment conducted in the spa and in outpatient clinic. Observation included 120 persons with disorders of the musculoskeletal system treated in the spa Przerzeczyn-Zdrój. The second group of patients was treated in the rehabilitation clinic. The examinations were performed before and after treatment. The scope of the observations included self-evaluation of anxiety treated as a state and a trait, the level of intensity of pain, medical history, and sociodemographic background interview. In the observations, there were VAS scale and State Trait Anxiety Inventory STAI used.

Result

As a result of the spa therapy and therapy performed in an outpatient clinic, there was an improvement in lowering the level of pain and anxiety noted.

Conclusions

1. Spa therapy and treatment performed in an outpatient clinic reduce the level of pain and anxiety in patients with degenerative disease of the musculoskeletal system. 2. It was found that the therapy conducted in the spa was more effective in lowering the level of pain and anxiety. This trial is registered with NCT03405350.

Exploring Post-traumatic Growth in Parkinson's Disease: A Mixed Method Study

Post-traumatic growth (PTG) may favor the psychological adaptation to chronic illnesses. However, few studies investigated PTG in Parkinson's Disease (PD). This study aims to investigate PTG in patients with PD, by exploring disease-specific features and assessing its impact on distress, well-being, and quality of life. A mixed methodology with a convergent parallel design was used. 54 patients were classified according to their level of PTG (low PTG, medium PTG, and high PTG). PD patients with high PTG showed a more positive psychological adaptation and less distress when compared to patients with less PTG. Forty-nine patients were interviewed and their transcripts were analyzed using Thematic Analysis. The emerged themes confirmed the traditional dimensions of PTG model, but a specific theme connected to a new body awareness was identified. Patients with high PTG were more likely to report positive statements following PD diagnosis, particularly concerning spirituality and maintaining a good physical functioning. PTG presents peculiar characteristics in PD and it may favor a better psychological adjustment following the diagnosis.

Examining the impact of cancer on survivors' religious faith: A report from the American Cancer Society study of cancer survivors-I

OBJECTIVES

The impact of religion/spirituality (R/S) on cancer outcomes, including health-related quality of life (HRQoL), has been the topic of much investigation. Reports of the opposite, that is, the impact of cancer on R/S and associations with HRQoL, are few. The current study sought to explore the positive and negative impacts of cancer on the religious faith of survivors as well as the associations of such impacts with HRQoL.

METHODS

Participants included 2309 9-year survivors of cancer from the American Cancer Society's Studies of Cancer Survivors-I. The impact of cancer on R/S was measured using items from the Patient-Reported Outcomes Measurement Information System (PROMIS) psychosocial impact of illness-faith, and HRQoL was measured with the 12-item short form (SF-12). Hierarchical regressions were used to examine the impact of cancer on R/S controlling for medical and demographic covariates.

RESULTS

Consistent with hypotheses, the majority of survivors (70%) reported that cancer had a positive impact on religious faith, while the negative impact of cancer on religious faith was relatively rare (17%). In multivariable models, the negative impact of cancer on faith was associated with poorer HRQoL, both mental and physical, while the positive impact of cancer on faith was associated with greater mental well-being.

CONCLUSIONS

Cancer has a negative impact on religious faith for a minority of survivors. However, when it is reported, such negative impact is indicative of poorer mental and physical well-being. As such, it is important to identify those survivors at risk early in survivorship and provide support and intervention as needed.

Motivation of cancer patients to help others and the relation between posttraumatic growth and helping

Background

Posttraumatic growth (PTG) is related to positive psychological changes following people’s struggle with trauma. The PTG model suggests that one of its possible consequences may be higher motivation towards helping behaviours. The aim of the research was to explore the influence of cancer illness on the motivation to help others, as perceived by participants, and the mechanisms behind such behaviour.

Participants and procedure

Quantitative and qualitative methods were used to explore the main motives to help others among cancer patients. The study also investigated the relation of perceived growth (PTG) and the frequency of providing help. Female cancer patients (n = 100) com-pleted a Polish version of the Posttraumatic Growth Inventory and a questionnaire measuring frequency of providing help to-wards ill and healthy individuals. Some of the subjects (n = 29) were also interviewed to assess the main perceived motives to help others.

Results

Positive rho Spearman correlations between PTG and the frequency of help given towards ill individuals and healthy ones were found. Based on thematic analysis four motives of helping were identified: empathy, self-enhancement, internalized standards of behaviour, searching for the sense of life.

Conclusions

This findings highlight the positive association between cancer patients’ involvement in helping other cancer patients and posi-tive life changes after experience of cancer.