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Zhu X, Qu Y, Zhang Y, Jin S, Wang H, Wang L, Zhuang S. Characterizing the post-traumatic growth trajectory in gastric cancer survivors: a population-based longitudinal study. Support Care Cancer 2024; 32:483. [PMID: 38958751 DOI: 10.1007/s00520-024-08697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES Post-traumatic growth can improve the quality of life of cancer survivors. The objective of this study was to investigate post-traumatic growth heterogeneity trajectory in perioperative gastric cancer survivors, and to identify characteristics that predict membership for each trajectory. METHODS Gastric cancer survivors (n = 403) were recruited before surgery, their baseline assessment (including post-traumatic growth and related characteristics) was completed, and post-traumatic growth levels were followed up on the day they left the intensive care unit, at discharge, and 1 month after discharge. Latent growth mixture mode was used to identify the heterogeneous trajectory of post-traumatic growth, and the core predictors of trajectory subtypes were explored using a decision tree model. RESULTS Three post-traumatic growth development trajectories were identified among gastric cancer survivors: stable high of PTG group (20.6%), fluctuation of PTG group (44.4%), persistent low of PTG group (35.0%). The decision tree model showed anxiety, coping style, and psychological resilience-which was the primary predictor-might be used to predict the PTG trajectory subtypes of gastric cancer survivors. CONCLUSIONS There was considerable variability in the experience of post-traumatic growth among gastric cancer survivors. Recognition of high-risk gastric cancer survivors who fall into the fluctuation or persistent low of PTG group and provision of psychological resilience-centered support might allow medical professionals to improve patients' post-traumatic growth and mitigate the impact of negative outcomes.
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Affiliation(s)
- Xinran Zhu
- School of Nursing, Tianjin Medical University, 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
| | - Yitong Qu
- School of Nursing, Tianjin Medical University, 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
| | - Yinan Zhang
- School of Nursing, Tianjin Medical University, 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
| | - Shimei Jin
- School of Nursing, Tianjin Medical University, 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
| | - Huiying Wang
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Lina Wang
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Shumei Zhuang
- School of Nursing, Tianjin Medical University, 22 Meteorological Station Road, Heping District, Tianjin, 300070, China.
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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Longcoy LTH, Wu WW, Wei CJ, Doorenbos AZ. Examining the Role of Resilience, Posttraumatic Growth, and Quality of Life in Women with Breast Cancer: A Serial Multiple Mediator Model Approach. Semin Oncol Nurs 2023; 39:151441. [PMID: 37149439 PMCID: PMC10524348 DOI: 10.1016/j.soncn.2023.151441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES It is unclear how resilience and posttraumatic growth help women with breast cancer face cancer-related symptom distress. This study included both resilience and posttraumatic growth as mediators in a serial multiple mediator model to examine changes in the relationship between symptom distress and quality of life among women with breast cancer. DATA SOURCES We conducted the descriptive, cross-sectional study in Taiwan. Data were collected using a survey that assessed symptom distress, resilience, posttraumatic growth, and quality of life. A serial multiple mediator model examined one direct and three specific indirect effects of symptom distress on quality of life through resilience and posttraumatic growth. All 91 participants reported the presence of symptom distress and moderate levels of resilience. Quality of life was significantly associated with symptom distress (b = -1.04), resilience (b = 0.18), and posttraumatic growth (b = 0.09). The indirect effect of symptom distress on quality of life through resilience alone was statistically significant (b = -0.23, 95% CI -0.44 to -0.07) and statistically greater than the specific indirect effect through resilience and posttraumatic growth combined (b = -0.21, 95% CI -0.40 to -0.05). CONCLUSION Resilience plays a unique role in reducing the impact of symptom distress on the quality of life among women with breast cancer. IMPLICATIONS FOR NURSING PRACTICE Given the importance of resilience to quality of life, oncology nurses can assess the resilience of women with breast cancer and help identify available internal, external, and existential resources to strengthen their resilience.
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Affiliation(s)
- Li-Ting H Longcoy
- Postdoctoral Fellow, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Wei-Wen Wu
- Associate Professor; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chung-Jen Wei
- Associate Professor; Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ardith Z Doorenbos
- Professor; College of Nursing, University of Illinois Chicago, Chicago, Illinois
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Moore JB, Rubin KCR, Heaney CA. Benefit finding and well-being over the course of the COVID-19 pandemic. PLoS One 2023; 18:e0288332. [PMID: 37498840 PMCID: PMC10374125 DOI: 10.1371/journal.pone.0288332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
This study focuses on understanding benefit finding, the process of deriving growth from adversity, and its relationship to well-being amidst the COVID-19 pandemic. Participants (n = 701) completed online surveys at 1, 3, 6, and 12 months after a shelter-in-place mandate was announced in California, USA. Identifying as female or of Asian descent, having a supportive social network, and reporting more distress were associated with higher levels of general benefit finding at all data collection points, while other demographics were not. Benefit finding exhibited small but statistically significant associations with two measures of well-being. Understanding the extent to which various groups of people experience benefit finding during ongoing adversity and how such benefit finding is associated with well-being may help to promote mental health during a collective trauma like the COVID-19 pandemic.
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Affiliation(s)
- Jessie B Moore
- Stanford Prevention Research Center, Stanford School of Medicine, Stanford, California, United States of America
| | - Katharine C R Rubin
- Stanford Prevention Research Center, Stanford School of Medicine, Stanford, California, United States of America
| | - Catherine A Heaney
- Stanford Prevention Research Center, Stanford School of Medicine, Stanford, California, United States of America
- Department of Psychology, Stanford University, Stanford, California, United States of America
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Matsui T, Taku K. Relationship between posttraumatic growth and help-seeking behavior in use of psychosocial support services among patients with cancer. J Cancer Surviv 2023:10.1007/s11764-023-01418-w. [PMID: 37464204 DOI: 10.1007/s11764-023-01418-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 06/15/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Cancer survivors who used psychosocial support services often report posttraumatic growth (PTG). This refers to positive psychological changes that may occur as the five domains as a result of the challenges they face. Opposing relationship also might exist. This study aimed to examine the relationship between PTG and help-seeking behavior (HSB). METHODS In total, 710 participants completed an online survey at Time1. Of those, 395 who reported not using any psychosocial support services at Time1 were asked to participate in the Time2 survey and completed a questionnaire. The participants provided demographic information, the experiences of using psychosocial support services, and the overall and five domains of PTG. RESULTS Those who experienced HSB at Time1 reported a higher PTG, and two of the PTG domains, Appreciation of Life and New Possibilities, than those who did not used services. Mixed ANOVAs showed the main effects of the HSB on the overall PTG, Appreciation of Life, and New Possibilities. Hierarchical logistic regression analyses showed that Appreciation of Life at Time1 was significantly related to the engaging in HSB at Time2. CONCLUSION Those who received psychosocial support services reported a higher PTG. Participants may have also engaged in HSB because they had experienced PTG. People who are likely to seek help and experience PTG may share common characteristics. IMPLICATIONS FOR CANCER SURVIVORS Support for those who do not fit the existing PTG and the use of psychosocial support services should also be considered.
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Affiliation(s)
- Tomoko Matsui
- Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita City, Osaka Prefecture, Japan.
| | - Kanako Taku
- Department of Psychology, Oakland University, Rochester, MI, USA
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Xie C, Li L, Li Y. Trajectories of Learned Helplessness in Maintenance Haemodialysis Patients and Their Predictive Effects on Self-Management: A Latent Growth Mixture Modeling Approach. Psychol Res Behav Manag 2023; 16:351-361. [PMID: 36798876 PMCID: PMC9926927 DOI: 10.2147/prbm.s401380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Background Learned helplessness (LH) is an essential psychological factor influencing maintenance haemodialysis (MHD) patients' health behaviour and is closely related to prognosis of the disease. This study aimed to identify potential trajectories of LH in MHD patients and assess their predictive role in self-management. Methods This study was conducted in strict compliance with national laws, the Declaration of Istanbul, and the Declaration of Helsinki. A total of 347 MHD patients at a blood purification centre in Hunan Province, China, were selected as the study population. Four longitudinal surveys (baseline and second/fourth/sixth month after baseline) were conducted using the General Information Questionnaire for MHD patients, the Chinese version of the Learned Helplessness Scale for MHD patients, and the Self-Management Scale for Haemodialysis. Latent growth mixture model (LGMM) analysis was used to identify LH trajectories, and their predictors were analysed using multinomial logistic regression. The predictive role of LH trajectory on self-management was analysed using linear regression. Results This study identified three LH trajectories in MHD patients, named the "high-decreasing group" (57.9%), "low-increasing group" (21.3%), and "low-stability group" (20.7%). The results of the univariate analysis showed that sex (χ2=33.777, P < 0.001), age (χ2=10.605, P<0.05), and subjective social status (SSS) (χ2=12.43, P<0.01) were associated with LH trajectory classes. Multinomial logistic regression further demonstrated that gender, age, and SSS were predictors of different LH trajectories. The intercept and slope of the overall LH trajectory were negatively correlated with self-management (β=-0.273, P<0.001; β=-0.234, P<0.01). Conclusion MHD patients show three different LH trajectories. The initial level and developmental rate of LH can negatively predict future self-management. It is necessary to screen MHD patients' LH and develop targeted interventions for them with different LH trajectories at specific stages.
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Affiliation(s)
- Chunyan Xie
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China,XiangYa Nursing School, Central South University, Changsha, People’s Republic of China
| | - Li Li
- XiangYa Nursing School, Central South University, Changsha, People’s Republic of China,The First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China,Correspondence: Yamin Li, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China, Email
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Khalid S, Abbas I, Javed S. Psychological Support for Cancer Patients. Cancer Treat Res 2023; 185:255-283. [PMID: 37306913 DOI: 10.1007/978-3-031-27156-4_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
From the time a person is diagnosed with cancer, a psychological sequalae of intense emotional challenges emerge for the patient as well as family members. Different stages require different types of psychosocial support including those for previvors, survivors, and people who need palliative care. Currently, there is an emphasis on not only providing psychological assistance to cope with emotional, interpersonal, and economic stresses, but training programs specially designed to activate personal and social resources to find happiness and meaning in adversity. Within this perspective, the chapter is divided into three sections, each considering the common mental health issues and positive changes and intervention and therapies for cancer patients, family members, caregivers, onco-staff, and professionals.
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Affiliation(s)
- Shazia Khalid
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
| | - Imran Abbas
- Oncoplastic Breast Surgeon, Royal Cornwall Hospitals, NHS Trust, Cornwall, UK
| | - Saira Javed
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
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Knauer K, Bach A, Schäffeler N, Stengel A, Graf J. Personality Traits and Coping Strategies Relevant to Posttraumatic Growth in Patients with Cancer and Survivors: A Systematic Literature Review. Curr Oncol 2022; 29:9593-9612. [PMID: 36547168 PMCID: PMC9776882 DOI: 10.3390/curroncol29120754] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
The possibility of positive psychological changes after cancer, namely, posttraumatic growth, is a growing field of research. Identifying personality traits and coping strategies related to posttraumatic growth may help find vulnerable individuals as well as promote helpful coping strategies to help more patients make positive changes at an early stage. The aim of this systematic literature review is to provide an overview of the quantitative data on coping strategies and personality traits associated with posttraumatic growth in patients with cancer and cancer survivors as well as the methods used in included studies. A systematic literature search was conducted using five databases (PubMed, PubPsych, PsycInfo, Web of Science, and PSYNDEXplus). The 70 reports of included studies assessed posttraumatic growth using questionnaires in a sample of patients with cancer or survivors. In addition, associations with a personality trait or coping strategy had to be examined cross-sectionally or longitudinally. All 1698 articles were screened for titles and abstracts by two authors, after which disputed articles were reviewed by a third author. Afterwards, articles were screened for full texts. Most studies had a cross-sectional design and used a sample of patients with breast cancer. Coping strategies have been researched more than personality factors. The personality traits of resilience, hardiness, dispositional positive affectivity, and dispositional gratitude seem to be related to posttraumatic growth, while the Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, neuroticism) have been less researched and/or seem to be unrelated. The use of social support, religious coping, positive reframing, and reflection during illness as coping strategies seems to be related to posttraumatic growth. The findings can be used for the development of interventions. Future studies should investigate associations longitudinally.
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Affiliation(s)
- Klara Knauer
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
- Correspondence:
| | - Anne Bach
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
| | - Norbert Schäffeler
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
| | - Andreas Stengel
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany
| | - Johanna Graf
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
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Dubuy Y, Sébille V, Bourdon M, Hardouin JB, Blanchin M. Posttraumatic growth inventory: challenges with its validation among French cancer patients. BMC Med Res Methodol 2022; 22:246. [PMID: 36153507 PMCID: PMC9508777 DOI: 10.1186/s12874-022-01722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Background The Posttraumatic growth inventory (PTGI) aims to assess the positive psychological changes that individuals can perceive after a traumatic life event such as a cancer diagnosis. Several French translations of the PTGI have been proposed, but comprehensive data on their psychometric properties are lacking. This study aimed to provide a more complete assessment of the psychometric properties of one of the most used PTGI translations in early-stage breast cancer and melanoma patients. Methods A sample of 379 patients completed the PTGI two years after their cancer diagnosis. A confirmatory analysis was first performed to determine whether the initial five-factor structure of the PTGI was adequate for this French version. As issues were identified in the translation and in the questionnaire structure, we performed an exploratory analysis to determine the most suitable structure for this questionnaire. Validity and reliability of the evidenced structured were then assessed. Results The exploratory analysis evidenced a four-factor structure close to the initial structure: four of the five initial domains were recovered, and items from the unrecovered domain were split into the other domains. This new structure showed good internal consistency and acceptable validity. Conclusions This study highlights that the process of translation and cross-cultural validation of questionnaires is crucial to obtain valid and reliable psychometric instruments. We advise French psycho-oncology researchers and psychotherapists to (i) use the revised translation of Lelorain et al. (2010) proposed in this manuscript and (ii) use the four scores newly evidenced with a grouping of two response categories. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01722-6.
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Social Support Is Linked to Post-Traumatic Growth among Tunisian Postoperative Breast Cancer Women. Healthcare (Basel) 2022; 10:healthcare10091710. [PMID: 36141321 PMCID: PMC9498750 DOI: 10.3390/healthcare10091710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022] Open
Abstract
The struggle with breast cancer (BC) is often associated with positive changes after diagnosis and treatment, that are being referred to as posttraumatic growth (PTG). We aimed to examine PTG and its relationship with psychosocial (i.e., psychological distress, spiritual well-being, social support), sociodemographic and cancer-related variables in Tunisian women operated on for breast cancer. This was a cross-sectional study. Seventy-nine (79) postoperative BC women were administered the Post-Traumatic Growth Inventory, the Spiritual Well-being Scale, the Depression, Anxiety and Stress Scales, and the Multidimensional Scale of Perceived Social Support. The changes most frequently reported by participants were discovering that they were stronger than they thought they were (70.0%), having stronger religious faith (65.0%), and being better able to accept the way things work out (63.8%). Multivariate analysis showed that anxiety and social support remained significantly associated with PTG, while no significant relationship has been found for spiritual well-being. Overall, the present study adds to the existing body of research by identifying factors related to women’ s experience of PTG in a previously unexplored Arab Muslim cultural context, Tunisia. We believe that our findings may help inform strategies aiming at promoting positive psychological changes after experiencing BC, at least in our context.
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Tu PC. The effects of trait resilience and rumination on psychological adaptation to breast cancer. Health Psychol Open 2022; 9:20551029221140765. [PMID: 36386252 PMCID: PMC9659940 DOI: 10.1177/20551029221140765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This cross-sectional study examined the effect of trait resilience and specific types of rumination on positive psychological adaptation post-diagnosis among 201 breast cancer patients. They completed self-reported measures describing trait resilience, rumination, posttraumatic growth, and health-related quality of life. Hierarchical analysis showed that trait resilience significantly predicted higher quality of life and posttraumatic growth after controlling for demographic and clinical variables. Additionally, “intrusion” and “brooding” subtypes of rumination negatively predicted quality of life, with “instrumentality” positively predicting quality of life and posttraumatic growth, suggesting the importance of trait resilience and multidimensional rumination for positive psychological changes among breast cancer survivors.
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Affiliation(s)
- Pei-Chiung Tu
- Department of Psychology, Chung Yuan Christian University, Taoyuan City, Taiwan
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Post-Traumatic Growth in Women with Breast Cancer: Intensity and Predictors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116509. [PMID: 35682111 PMCID: PMC9180473 DOI: 10.3390/ijerph19116509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022]
Abstract
Experiencing a traumatic situation such as breast cancer can, beside negative consequences, have a positive impact, described as post-traumatic growth (PTG). A factor that facilitates psychological recovery when coping with stressful events is psychological resilience. The aim of the present study was to assess whether PTG occurs in a group of women with breast cancer and whether resilience is a personal trait contributing to its occurrence. The study group comprised 100 women with breast cancer, aged 31-80 years, almost half of whom were aged 61-70 years (n = 46, 46%). The Post-Traumatic Growth Inventory, the Impact of Event Scale, and the Resilience Assessment Questionnaire (KOP) were used for the study. All women manifested PTG, with a mean intensity of 76.61 ± 13.45 points. The greatest changes were observed in the subjects' appreciation of life, and the smallest in their relations with others, self-perception, and spiritual changes. The KOP scale measured a mean resilience of 103.80 ± 16.57. The results obtained confirm the co-occurrence of psychological resilience and PTG, especially personal resilience and social competences. Additionally, women subjected to additional traumatic events other than cancer manifested a higher level of PTG.
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Posttraumatic growth and its association with unmet supportive care needs and fear of cancer progression among head and neck cancer patients. PLoS One 2022; 17:e0265502. [PMID: 35290419 PMCID: PMC8923508 DOI: 10.1371/journal.pone.0265502] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/02/2022] [Indexed: 01/04/2023] Open
Abstract
Background and aims The assessment of supportive care needs and fear of cancer progression are important variables to be considered when evaluating the psychological aspects of cancer patients. However, data on how these variables affect posttraumatic growth (PTG) are lacking. This study aimed to investigate the level of PTG among head and neck cancer (HNC) patients within the first year of cancer diagnosis and to determine the association between unmet supportive care needs, fear of cancer progression, and the level of PTG. Methods Participants were administered socio-demographic and clinical characteristics questionnaire; the 34-item Supportive Care Needs Survey (SCNS-34) to measure the unmet needs; 12-item Fear of Progression Questionnaire-Short Form (FoP-Q-SF) to measure the fear of progression of cancer; and the Posttraumatic Growth Inventory—Short Form (PTGI-SF) to measure the degree of PTG. Results A total of 190 HNC participants reported a mean total PTGI-SF score of 39.3 (standard deviation = 9.5). General linear model revealed that higher degree of patients’ physical and daily living unmet needs and fear of cancer progression significantly predicted lower PTG, after controlling for sociodemographic and clinical factors. Conclusion HNC patients within the first year of cancer diagnosis reported a high level of PTG. Despite that, psychosocial intervention for HNC patients should emphasize on counteracting patients’ physical and daily living unmet needs and fear of cancer progression to improve the psychological well-being of patients.
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Milhabet I, Dias P, Christophe V, Le Barbenchon E. Perceived trajectory of psychological and physical states after breast cancer: An optimistic perception. J Psychosoc Oncol 2021; 40:614-631. [PMID: 34847826 DOI: 10.1080/07347332.2021.1968095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In cancer research, studying the quality of life trajectory helps us understand the complaints but also the cognitive, physical, and emotional aspects that can evolve positively. Examining both the suffering and the improvements expressed by the patients facilitates their care and their recovery knowing that an optimistic perception of the future is important for adaptative functioning after cancer. Through retrospective, present and prospective measures, we sought to characterize the subjective trajectory perceived by women with breast cancer about their cognitive, emotional and physical states, as it relates to quality of life. METHODS Nine hundred ninety women survivors of breast cancer (after curative treatments) described, on the appropriate scales, their perceived cognitive, emotional and physical states over three periods of time: from past care (i.e., retrospective analysis) to the future (i.e., projective analysis), including the present period, as a function of their treatment (chemotherapy vs. no chemotherapy) and surgery (lumpectomy vs. mastectomy) using ANCOVA. RESULTS The 732 women who had received chemotherapy perceived the most significant consequences, regardless of the type of surgery (η2= .01). Moreover, all survivors expressed an optimistic perception of the change in their states in the anticipated future as a normative optimistic perception. CONCLUSIONS Results are discussed in terms of the benefits of specific and early interventions that enable patients to cope better with the disease and its treatments by taking into account their more or less optimistic perception of the future.
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Affiliation(s)
- Isabelle Milhabet
- Laboratory LAPCOS 7278/EUR ODYSSEE, University of Cote d'Azur, Nice, France
| | - Pierre Dias
- UMR CNRS 7300 Laboratory ESPACE, Aix-Marseille University, Marseille, France
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Zhao J, An Y, Li X, Huang J. After Experiencing a Tornado: Adolescents' Longitudinal Trajectories in Posttraumatic Growth and Their Association with Posttraumatic Stress Symptoms. Child Psychiatry Hum Dev 2021; 54:786-795. [PMID: 34843034 DOI: 10.1007/s10578-021-01278-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
This study investigated the trajectories in posttraumatic growth (PTG) among adolescents who survived from the Yancheng tornado in China, and explored the effects of posttraumatic stress symptoms (PTSS) on these trajectories. Participants (n = 246) finished 4 assessments at 6, 9, 12, and 18 months after the tornado. Growth mixture model and logistic regression were used to examine the heterogeneous trajectories and the role of PTSS for differentiating trajectories respectively. Two latent PTG trajectories were observed: group with decreasing PTG and group with fluctuant PTG, which might stem from the illusory component and the factual component of PTG respectively based on the two-component model; and adolescents with more PTSS had higher probabilities generating decreasing PTG, that is, illusory PTG. This study suggested differentiating PTG trajectories and related influencing factors to improve the post-disaster psychological interventions in a longitudinal perspective.
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Affiliation(s)
- Jiaqi Zhao
- School of Psychology, Nanjing Normal University, No. 122 Ninghai Road, Gulou District, Nanjing, 210097, People's Republic of China
| | - Yuanyuan An
- School of Psychology, Nanjing Normal University, No. 122 Ninghai Road, Gulou District, Nanjing, 210097, People's Republic of China.
| | - Xiaohui Li
- School of Family and Consumer Sciences, Northern Illinois University, DeKalb, USA
| | - Jiali Huang
- School of Psychology, Nanjing Normal University, No. 122 Ninghai Road, Gulou District, Nanjing, 210097, People's Republic of China
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16
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Nik Jaafar NR, Abd Hamid N, Hamdan NA, Rajandram RK, Mahadevan R, Mohamad Yunus MR, Zakaria H, Leong Bin Abdullah MFI. Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time? Front Psychol 2021; 12:716674. [PMID: 34764904 PMCID: PMC8576436 DOI: 10.3389/fpsyg.2021.716674] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
| | - Norhaliza Abd Hamid
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - Nur Amirah Hamdan
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
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Jayawickreme E, Blackie LER, Forgeard M, Roepke AM, Tsukayama E. Examining Associations Between Major Negative Life Events, Changes in Weekly Reports of Post-Traumatic Growth and Global Reports of Eudaimonic Well-Being. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2021. [DOI: 10.1177/19485506211043381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Research on post-traumatic growth (PTG) has been compromised by methodological limitations. Recent process-oriented accounts of personality suggest, however, that positive changes may occur through short-term (i.e., state-level) changes in PTG. In the current year-long study, 1,247 participants provided weekly reports of significant negative events as well as state manifestations of PTG (up to 44 assessments per individual; 34,205 total). Trait assessments of eudaimonic well-being (EWB) were administered at intake and Weeks 45 and 52. Experiencing negative life events predicted increases in state PTG, which in turn predicted increases in EWB. However, stability was observed when modeling prospective changes in overall state PTG before and after the initial negative life event or across all negative life events occurring during the study time frame. These findings highlight the importance of studying PTG-related processes using appropriate research designs, analytic strategies, and time frames.
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Affiliation(s)
- Eranda Jayawickreme
- Department of Psychology & Program for Leadership and Character, Wake Forest University, Winston-Salem, NC, USA
| | | | - Marie Forgeard
- Clinical Psychology Department, William James College, Newton, MA, USA
| | | | - Eli Tsukayama
- Department of Business Administration, University of Hawaii-West Oahu, Kapolei, HI, USA
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18
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Anthony E, Files K, Danhauer SC. Leaning Into Uncertainty and Discomfort With Hope. JAMA Oncol 2021; 7:1117-1118. [PMID: 34081071 DOI: 10.1001/jamaoncol.2021.1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Evelyn Anthony
- Department of Radiology and Office of Faculty Affairs, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Katherine Files
- Department of Communications, Marketing & Media, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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19
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Shi G, Shi T, Liu Y, Cai Y. Relationships between dyadic coping, intimate relationship and post-traumatic growth in patients with breast cancer: A cross-sectional study. J Adv Nurs 2021; 77:4733-4742. [PMID: 34227131 DOI: 10.1111/jan.14946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
AIM To investigate the relationships and pathways between dyadic coping, intimate relationship and post-traumatic growth (PTG) in Chinese patients with breast cancer. DESIGN A cross-sectional study. METHODS Between November 2019 and November 2020, 133 patients with breast cancer who received therapy in tertiary grade-A hospitals at Dalian, China completed questionnaires including demographic and clinical questionnaires, Locke-Wallace Marriage Adjustment Test, Chinese version of the Dyadic Coping Inventory and Chinese version of the Post-traumatic Growth Inventory. Structural equation modelling was used to analyse the pathways. RESULTS Dyadic coping was positively interrelated with PTG and intimate relationship (r = .355, p < .01; r = .213, p < .05); intimate relationship was negatively interrelated with PTG (r = -.207, p < .05). The structural equation model demonstrated adequate fit. Dyadic coping and intimate relationship directly affected PTG (β = .469, p < .05; β = -.309, p < .05). Dyadic coping indirectly affected PTG through intimate relationship (β = -.066, p < .05). CONCLUSIONS Dyadic coping was a stimulus factor, but intimate relationship was an obstructive factor in enhancing PTG for the Chinese patients with breast cancer. Furthermore, intimate relationship may have significant mediating effects in the link between dyadic coping and PTG. Strategies that improve dyadic coping level and avoid excessive intimacy relationships between couples contribute to the development of PTG among patients with breast cancer. IMPACT The research provides new ideas and intervention entry points for global nurses and psychotherapists so that they can enact and implement targeted PTG intervention plans for patients with breast cancer worldwide.
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Affiliation(s)
- Genya Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tieying Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Liu
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yingjie Cai
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China.,Nursing Department, Chiba University, Chiba, Japan
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20
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Gorven A, du Plessis L. Corporeal Posttraumatic Growth As a Result of Breast Cancer: An Interpretative Phenomenological Analysis. JOURNAL OF HUMANISTIC PSYCHOLOGY 2021. [DOI: 10.1177/0022167818761997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women’s traumatic experience of breast cancer (BC) can result in posttraumatic growth (PTG). Women’s embodied experiences of BC seem particularly pertinent to their experiences of both difficulty and growth. While PTG is usually conceptualized as having five domains, it seems that BC survivors experience a sixth domain—corporeal PTG (CPTG). CPTG was recently defined as a “reclaiming” and renewed connection to the body through increased appreciation of the physical self, a new sense of bodily responsibility, positive health changes, and a new sense of positive identification with the body. This study’s aim was to explore how women experience CPTG due to BC. In-depth interviews were conducted with female BC survivors. Interpretative phenomenological analysis extracted three themes: losing, regaining, and relinquishing ultimate control over the body, reconstructing embodied identity, and a newfound appreciation for the body. Participants spoke of a complicated journey from distress, loss, and fragmentation to a reshaping of their assumptions about their bodies. The findings suggest that the body plays a vital role in women’s traumatic and growth-related experiences of BC. Future research on the embodied experience of BC is recommended as it forms a crucial part of BC recovery.
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Affiliation(s)
- Amy Gorven
- University of Johannesburg, Johannesburg, Gauteng, South Africa
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21
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Posttraumatic stress disorder and growth: Examination of joint trajectories in children and adolescents. Dev Psychopathol 2021; 34:1353-1365. [PMID: 34092267 DOI: 10.1017/s0954579421000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Positive health endpoints are not the opposite of negative endpoints. Previous studies examining posttraumatic stress disorders (PTSD) and posttraumatic growth (PTG) trajectories have overlooked the co-existence of PTSD and PTG, making it difficult to accurately distinguish individuals with various posttraumatic presentations, causing the effects of targeted interventions to be discounted. To fill this gap, the current study sought to examine joint PTSD and PTG trajectories in children and adolescents. Eight hundred and seventy-six Chinese children and adolescents were recruited to complete self-report questionnaires 6, 12, and 18 months after the Ya'an earthquake. Multiple-process growth mixture modeling analysis was used to test the study proposal. Five distinct joint PTSD and PTG trajectory types were found: recovery, growth, struggling, resistant, and delayed symptoms. Female students and students who felt trapped or fearful were more likely to be in the struggling group, and students who experienced injury to themselves or family members were more likely to belong to the delayed symptom group. These findings suggest that postdisaster psychological services should be provided to relieve delayed symptoms in individuals who experience injury to themselves or their family members, and individuals in the struggling group should be supported to achieve growth.
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22
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Kyutoku Y, Dan I, Yamashina M, Komiyama R, Liegey‐Dougall AJ. Trajectories of Posttraumatic Growth and Their Associations With Quality of Life After the 2011 Tohoku Earthquake and Tsunami. J Trauma Stress 2021; 34:512-525. [PMID: 33227166 PMCID: PMC8246896 DOI: 10.1002/jts.22628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/12/2020] [Accepted: 10/24/2020] [Indexed: 11/07/2022]
Abstract
The 2011 Tohoku earthquake and tsunami in Japan was an extraordinarily stressful incident that caused harmful psychological reactions, such as posttraumatic stress disorder (PTSD), among affected individuals. However, a proportion of exposed individuals experienced posttraumatic growth (PTG), characterized by a noticeable degree of personal strength, spirituality, life appreciation, perception of new possibilities in life, and enhanced relationships with others. Some researchers have argued that these positive reactions may be an illusory change related to coping with traumatic events. We examined trajectory patterns related to PTG Inventory (PTGI) subscales to elucidate the existence of both real and illusory growth regarding quality of life (QoL), utilizing group-based trajectory models. Three online questionnaires were distributed at 6 months (N = 2,554; M age = 47.04 years, SD = 12.62), 12 months (N = 887; M age = 48.11 years, SD = 12.43), and 42 months (N = 560; M age = 48.86 years, SD = 12.25) postdisaster. Participants responded to items related to demographic characteristics, disaster experiences, posttraumatic stress symptoms, PTG, and QoL. Three main PTG trajectories emerged, characterized by growth, no growth, and illusory growth, with QoL as a time invariant covariate. Compared with the growth trajectory, the odds ratios (ORs) for no growth ranged from 2.27 to 5.04; for illusory growth, the ORs ranged from 2.09 to 4.67. To our knowledge, this was the first study to report growth trajectories related to PTGI subscales and their underlying differences in psychological mechanisms and processes following the 2011 Tohoku earthquake and tsunami.
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Affiliation(s)
- Yasushi Kyutoku
- Research and Development InitiativeChuo UniversityTokyoJapan
| | - Ippeita Dan
- Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and EngineeringChuo UniversityTokyoJapan
| | - Mitsuru Yamashina
- Department of Psychology, Faculty of LettersChuo UniversityTokyoJapan
| | - Ren Komiyama
- Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and EngineeringChuo UniversityTokyoJapan
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23
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Zhang H, Ma W, Wang G, Wang S, Jiang X. Effects of psychosocial factors on posttraumatic growth among lung cancer patients: A structural equation model analysis. Eur J Cancer Care (Engl) 2021; 30:e13450. [PMID: 33817877 DOI: 10.1111/ecc.13450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 07/29/2020] [Accepted: 11/27/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate how locus of control, coping strategies, emotion regulation strategies and social support affect posttraumatic growth. METHODS A cross-sectional study design was adopted. A convenience sample of 540 patients with lung cancer was recruited from November 2016 to July 2017 at two tertiary grade A hospitals in China. The participants completed a series of questionnaires. Structural equation modelling was used to explore the effects of psychosocial factors on posttraumatic growth. RESULTS Social support had a direct positive effect on posttraumatic growth (β = 0.318, SE = 0.071, BC 95% CI = 0.252/0.390), and it also had indirect effects on posttraumatic growth (β = 0.112, SE = 0.023, BC 95%CI = 0.088/0.135) through mediating psychological factors. Coping strategies and the cognitive reappraisal emotion regulation strategy were the main mediating variables, explaining approximately 73.1% of the indirect effect between social support and posttraumatic growth. CONCLUSIONS Our study suggests that Chinese lung cancer survivors can show relatively high posttraumatic growth. There are many mediating paths between social support and posttraumatic growth. These results may help healthcare professionals to identify the psychosocial factors that may benefit lung cancer patients and develop interventions to promote posttraumatic growth.
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Affiliation(s)
- Huaguo Zhang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.,Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Weiguang Ma
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Guorong Wang
- Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Song Wang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolian Jiang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
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24
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Jones AC, Hilton R, Ely B, Gororo L, Danesh V, Sevin CM, Jackson JC, Boehm LM. Facilitating Posttraumatic Growth After Critical Illness. Am J Crit Care 2020; 29:e108-e115. [PMID: 32929457 PMCID: PMC7646602 DOI: 10.4037/ajcc2020149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The theory of posttraumatic growth arose from accounts of various trauma survivors experiencing not only distress but also growth and change. An intensive care unit admission is an unplanned, sudden, and traumatic experience, and many survivors have posttraumatic stress that can lead to posttraumatic stress disorder. Survivors leave the intensive care unit with new functional impairments that drive depression, and they frequently experience anxiety. Amidst the stress of understanding the trauma of an intensive care unit admission, survivors can grow in their world views, relationships, and sense of self. Understanding posttraumatic growth in intensive care unit survivors will inform health care providers on how to help survivors understand their new difficulties after an intensive care unit stay and facilitate growth. This article is a conceptual review of posttraumatic growth, identifiers of posttraumatic growth, and how the tenets of the posttraumatic growth theory apply to intensive care unit survivors. Health care professionals, specifically nurses, can incorporate practices into their care during and after the intensive care unit stay that encourage understanding and positive accommodation of new difficulties brought on by the intensive care unit hospitalization to support survivor growth. Opportunities for research include incorporating posttraumatic growth assessments into post-intensive care unit clinics, self-help materials, and various programs or therapies. Outcomes associated with posttraumatic growth are listed to suggest directions for research questions concerning posttraumatic growth in intensive care unit survivors.
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Affiliation(s)
- Abigail C Jones
- Abigail C. Jones is a research assistant, School of Nursing, Vanderbilt University and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee
| | - Rachel Hilton
- Rachel Hilton is a research assistant, School of Nursing, Vanderbilt University
| | - Blair Ely
- Blair Ely is a research assistant, Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - Lovemore Gororo
- Lovemore Gororo is an intensive care unit survivor and former patient at Vanderbilt University Hospital, Nashville, Tennessee
| | - Valerie Danesh
- Valerie Danesh is an assistant professor, School of Nursing, University of Texas at Austin, Austin, Texas, and a research scientist, Center for Applied Health Research, Baylor Scott & White Health, Dallas, Texas
| | - Carla M Sevin
- Carla M. Sevin is an assistant professor, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - James C Jackson
- James C. Jackson is a professor of medicine, Division of Allergy, Pulmonary, and Critical Care Medicine and Center for Health Services Research, Department of Medicine, Vanderbilt University School of Medicine; a professor, Geriatric Research, Education and Clinical Center Service and Clinical Research Center of Excellence, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System; and a professor, Department of Psychiatry, Vanderbilt Medical Center
| | - Leanne M Boehm
- Leanne M. Boehm is an assistant professor, School of Nursing, Vanderbilt University, and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
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25
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Tomaszek K, Muchacka-Cymerman A. Thinking about My Existence during COVID-19, I Feel Anxiety and Awe-The Mediating Role of Existential Anxiety and Life Satisfaction on the Relationship between PTSD Symptoms and Post-Traumatic Growth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7062. [PMID: 32992515 PMCID: PMC7579162 DOI: 10.3390/ijerph17197062] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The global outbreak of COVID-19set new challenges and threats for every human being. In the psychological field it is similar to deep existential crises or a traumatic experience that may lead to the appearance or exacerbation of a serious mental disorder and loss of life meaning and satisfaction. Courtney et al. (2020) discussed deadly pandemic COVID-19 in the light of TMT theory and named it as global contagion of mortality that personally affected every human being. Such unique conditions activate existential fears as people start to be aware of their own mortality. OBJECTIVE The main aim of this study was to test the mediating effect of existential anxiety, activated by COVID-19 and life satisfaction (SWLS) on the relationship between PTSD symptoms and post-traumatic growth (PTG). We also examined the moderated mediating effect of severity of trauma symptoms on life satisfaction and existential anxiety and its associations with PTG. METHOD We conducted an online survey during the peak of the COVID-19 outbreak in Poland. The participants completed existential anxiety scale (SNE), life satisfaction scale (SWLS), IES-R scale for measuring the level of PTSD symptoms and post-traumatic growth inventory (PTGI). RESULTS The effect of PTSD on PTG was found to be mediated by existential anxiety and life satisfaction. We also confirmed two indirect effects: (1) the indirect effect of PTSD on PTG via existential anxiety and life satisfaction tested simultaneously; (2) the indirect effect of life satisfaction on PTG through severity of trauma symptoms. An intermediate or high level of PTSD level was related to less PTG when low and full PTSD stress symptoms strengthened PTG experiences. CONCLUSIONS A therapeutic intervention for individuals after traumatic experience should attempt to include fundamental existential questions and meaning of life as well as the severity of PTSD symptoms. The severity of traumatic sensations may affect the relationship between life satisfaction and post-traumatic growth.
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Affiliation(s)
| | - Agnieszka Muchacka-Cymerman
- Department of Psychosomatic, Institute of Psychology, Pedagogical University of Cracow, Podchorążych 2, 30-084 Kraków, Poland;
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26
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Fujimoto T, Okamura H. The influence of coping types on post-traumatic growth in patients with primary breast cancer. Jpn J Clin Oncol 2020; 51:85-91. [DOI: 10.1093/jjco/hyaa159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/07/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The physical and mental impacts of breast cancer diagnosis on women are substantial. Several studies have investigated the negative mental health effects of breast cancer. However, in recent years, there has also been growing interest in post-traumatic growth, a positive response to stressful events. Considering positive psychology focuses on such virtues, proactive coping theory was chosen as a theoretical guide. This study investigates how breast cancer patients’ post-traumatic growth is associated with proactive coping and mental well-being.
Methods
A self-administered questionnaire survey was conducted with 80 breast cancer patients aged 20–70 years attending an outpatient clinic. The survey was conducted using the Posttraumatic Growth Inventory-Japanese version (PTGI-J), Proactive Coping Inventory-Japanese version and the Japanese version of the General Health Questionnaire. Single regression and multiple regression analyses with PTGI-J as the dependent variable were performed.
Results
The multiple regression analysis extracted proactive coping (P = 0.006), emotional support seeking (P = 0.004) and avoidance coping (P = 0.001) as factors associated with post-traumatic growth in breast cancer patients.
Conclusions
These results suggest that using proactive coping for conflicts caused by a breast cancer diagnosis and temporary avoidant coping for daily stresses during the treatment process may enhance post-traumatic growth while preventing deterioration in mental well-being. Additionally, seeking emotional support is important for post-traumatic growth.
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Affiliation(s)
- Tomomi Fujimoto
- Department of Nursing, Faculty of Health Science, Aino University, Osaka, Japan
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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27
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Salawali SH, Susanti H, Daulima NHC, Putri AF. Posttraumatic growth in adolescent survivors of earthquake, tsunami, and liquefaction in Palu Indonesia: a phenomenological study. Pediatr Rep 2020; 12:8699. [PMID: 32905079 PMCID: PMC7463141 DOI: 10.4081/pr.2020.8699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
Exploration of posttraumatic growth (PTG) experiences in adolescent survivors of earthquakes, tsunamis, or liquefaction are needed by nurses to maximize the potential for recovery and growth of adolescents from trauma after natural disasters. The study used a qualitative method with a descriptive phenomenology approach. Data were collected through in-depth interviews with 16 adolescent survivors and were analyzed using the Colaizzi method. The results of this study have two main themes: trauma becoming the basis for realizing the meaning of life and escaping from disaster as a second chance to live better. PTG is a positive change that needs to be pursued. Escaping from disaster and realizing the meaning of life are the key points to get success in pursuing PTG to live a better life. In addition, support from mental health nurses through cognitive therapy (CT) and acceptance commitment therapy (ACT) are needed to increase the PTG.
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28
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Canada AL, Murphy PE, Stein K, Alcaraz KI, Leach CR, Fitchett G. Examining the impact of cancer on survivors' religious faith: A report from the American Cancer Society study of cancer survivors-I. Psychooncology 2020; 29:1036-1043. [PMID: 32128944 DOI: 10.1002/pon.5374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/14/2020] [Accepted: 02/29/2020] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
- Andrea L Canada
- Rosemead School of Psychology, Biola University, La Mirada, California, USA
| | - Patricia E Murphy
- Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois, USA
| | - Kevin Stein
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kassandra I Alcaraz
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - Corinne R Leach
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - George Fitchett
- Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois, USA
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The Relationship between Self-Perceived Burden and Posttraumatic Growth among Colorectal Cancer Patients: The Mediating Effects of Resilience. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6840743. [PMID: 31612145 PMCID: PMC6757246 DOI: 10.1155/2019/6840743] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Abstract
At present, the influence factors of posttraumatic growth (PTG) in colorectal cancer (CRC) patients and the relationship between PTG, self-perceived burden (SPB), and resilience are not completely clear. Thus, the present study examined whether resilience and SPB could predict PTG in CRC patients. The role of resilience as a potential mediator was also assessed. Using a cross-sectional design, a convenience sample of 157 CRC patients was selected as subjects, from July to December 2016 in a third-grade hospital. It was found that the main influencing factors for the total PTG score of CRC patients included work status, affordability for medical expenses, and duration of illness. Resilience was positively correlated with PTG, SPB was negatively correlated with PTG, and resilience played an intermediary role. Our findings remind clinicians to treat the psychosocial response of CRC patients from multiple perspectives, with a focus on their positive aspects. By increasing resilience and reducing the patient's SPB, clinicians might enhance the patient's PTG and quality of life.
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Zhou X, Zhen R, Wu X. Trajectories of posttraumatic growth among adolescents over time since the Wenchuan earthquake. J Adolesc 2019; 74:188-196. [DOI: 10.1016/j.adolescence.2019.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 11/27/2022]
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Markman ES, McClure KS, McMahon CE, Zelikovsky N, Macone BW, Bullock AJ. Social Problem Solving and Posttraumatic Growth New Possibilities in Postoperative Breast Cancer Survivors. J Clin Psychol Med Settings 2019; 27:518-526. [PMID: 31214814 DOI: 10.1007/s10880-019-09641-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to examine whether social problem solving (SPS) would relate to posttraumatic growth (PTG), particularly new life possibilities in breast cancer survivors. Participants included 85 women who had undergone surgical intervention for breast cancer at least 6 months prior to study participation. Participant ages ranged from 29 to 88 years. The majority of the sample was White (86%), married (58%), and had received at least some postsecondary education (73%), and all participants spoke English. This IRB-approved cross-sectional study was part of a larger study examining psychosocial protective and risk factors in breast cancer survivors at a university-affiliated private hospital. We hypothesized that better SPS ability would relate to PTG new possibilities above and beyond age, annual income, and time since surgery. Results from this study indicate that a positive problem orientation and lack of impulsive/careless problem-solving style appear to play a role in posttraumatic growth among breast cancer survivors, particularly in developing beliefs about one's ability to positively change one's life. Given the established benefits of active/approach coping in cancer populations, it makes sense that similar interventions such as problem-solving therapy, a cognitive-behavioral therapy that includes challenging and reframing negative beliefs about self and situation, may promote new possibility beliefs in this population.
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Affiliation(s)
- Elisabeth S Markman
- La Salle University, Philadelphia, USA. .,Department of Veterans Affairs, James A. Haley Veterans' Hospital, Tampa, FL, USA.
| | | | - Cori E McMahon
- La Salle University, Philadelphia, USA.,Cooper University Hospital, Camden, USA.,Tridiuum, Inc, Wayne, USA
| | - Nataliya Zelikovsky
- La Salle University, Philadelphia, USA.,Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Brian W Macone
- La Salle University, Philadelphia, USA.,University of Connecticut School of Medicine, Farmington, USA
| | - Anastasia J Bullock
- La Salle University, Philadelphia, USA.,Cooper University Hospital, Camden, USA
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Stanton AL, Wiley JF, Krull JL, Crespi CM, Weihs KL. Cancer-related coping processes as predictors of depressive symptoms, trajectories, and episodes. J Consult Clin Psychol 2018; 86:820-830. [PMID: 30265041 DOI: 10.1037/ccp0000328] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Although numerous studies address the relationships of depression with coping processes directed toward approaching or avoiding stressful experiences, the large majority are cross-sectional in design, assess coping processes at only one timepoint, or solely include prediction of the linear slope of depressive symptoms. In this research, coping processes were investigated as predictors of depressive symptoms, symptom trajectory classes (consistently high, recovery, consistently low), and major depressive episodes (MDEs) over 12 months in the cancer context. METHOD Women (N = 460) within 4 months of breast cancer diagnosis completed assessments of cancer-related coping processes, depressive symptoms, and MDEs at 7 points across 1 year. RESULTS Beyond sociodemographic and medical variables, coping through cancer-related avoidance an average of 2 months after diagnosis was associated with likelihood of being in the high depressive symptom trajectory class and occurrence of a MDE during the year. Less decline in avoidant coping over time also predicted poor outcomes. In contrast, high initial engagement in approach-oriented coping, as well as increases in coping through emotional expression and acceptance, were associated with lower depressive symptoms across assessments and higher likelihood of being in the recovery or low trajectory class. CONCLUSIONS Greater engagement in cancer-related avoidant coping was associated with all three indicators of depression, and greater approach-oriented coping was related to more favorable outcomes (except MDE). Sustained or increasing coping through emotional expression or acceptance predicted recovery from initially high depressive symptoms. Approach- and avoidance-oriented coping processes constitute malleable targets for preventive and ameliorative approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Catherine M Crespi
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles
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Taubman-Ben-Ari O, Skvirsky V, Strauss T, Morag I. Pre-term delivery, optimism and initial personal growth as predictors of mothers' long-term personal growth. J Reprod Infant Psychol 2018; 37:277-289. [PMID: 30525992 DOI: 10.1080/02646838.2018.1554245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Positive outcomes in the aftermath of childbirth have increasingly been studied in the last decade. However, most of the studies concentrate on short-term outcomes. The current study examined the perceived personal growth of mothers four years after childbirth, investigating the contribution of the event characteristics (full-term/pre-term birth), internal resources (optimism, self-esteem) and personal growth as measured one year after the birth. Methods: Mothers (n=259) participated in the study by completing a set of self-report questionnaires one and four years following the birth of their child/ren. Results: Personal growth after four years was found to be higher among mothers of pre-terms than of full-terms, and higher four years after the birth than it had been three years earlier. Furthermore, regression analysis indicated the significant contributions of being a mother to pre-term baby/ies, optimism and personal growth one year after the birth to women's personal growth three years later. Discussion: The results highlight the potential long-term effects of giving birth to a pre-term baby on personal growth, as well as the contribution of optimism as an important internal resource. They also indicate the development of personal growth over time. Explanations for the findings are offered and their practical implications are discussed.
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Affiliation(s)
- Orit Taubman-Ben-Ari
- a The Louis and Gabi Weisfeld School of Social Work , Bar Ilan University , Ramat Gan , Israel
| | - Vera Skvirsky
- a The Louis and Gabi Weisfeld School of Social Work , Bar Ilan University , Ramat Gan , Israel
| | - Tzipora Strauss
- b Department of Neonatology, the Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center and Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Iris Morag
- b Department of Neonatology, the Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center and Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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Paredes AC, Pereira MG. Spirituality, Distress and Posttraumatic Growth in Breast Cancer Patients. JOURNAL OF RELIGION AND HEALTH 2018; 57:1606-1617. [PMID: 28725952 DOI: 10.1007/s10943-017-0452-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Breast cancer is the most common type of cancer for women and is associated with increased distress. Spirituality and posttraumatic growth (PTG) have been associated with illness adjustment, but the relationship between these variables is still not well understood. A sample of 100 breast cancer patients completed a demographic and clinical questionnaire, the Posttraumatic Growth Inventory, Spiritual and Religious Attitudes in Dealing with Illness, and the Hospital Anxiety and Depression Scale. Results showed an association between PTG, spirituality and distress. Women with a longer diagnosis and recurrence showed more distress. Younger age, recurrent cancer and spirituality predicted higher PTG. Patients' spirituality should be part of intervention with breast cancer patients since it seems to be related to greater growth and adjustment to the illness.
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Affiliation(s)
| | - M Graça Pereira
- School of Psychology, University of Minho, 4710-057, Braga, Portugal.
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35
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Bachem R, Mitreuter S, Levin Y, Stein JY, Xiao Z, Solomon Z. Longitudinal Development of Primary and Secondary Posttraumatic Growth in Aging Veterans and Their Wives: Domain-Specific Trajectories. J Trauma Stress 2018; 31:730-741. [PMID: 30338589 PMCID: PMC6767582 DOI: 10.1002/jts.22331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 05/24/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
Abstract
Posttraumatic growth (PTG), the positive psychological transformations that follow traumatic events, affects both direct survivors (primary PTG) and their significant others (secondary PTG). Though primary and secondary PTG have been widely investigated in the literature, their long-term trajectories decades after a traumatic event, especially as survivors enter older age, remain largely uninvestigated. Furthermore, it remains contested whether PTG adds up to a monolithic construct or rather consists of relatively independent components. Addressing these issues, we assessed a sample of Israeli male veterans from the 1973 Yom Kippur war (N = 349) and their wives (N = 156) at three time points over the course of nearly three decades. Both the veterans (primary survivors) and their wives (secondary survivors) reported PTG relating to the veterans' experiences during the war and/or captivity. Latent growth mixture modeling was conducted to identify trajectories of PTG on the five subscales of the Posttraumatic Growth Inventory. Long-term trajectories of PTG followed heterogeneous patterns of fluctuation over time and particularly as participants entered older age. On most subscales, decreasing PTG scores were evident, a trend that was more pronounced among the primary survivors than the secondary survivors as primary and secondary PTG fluctuate considerably in the long-term and seem to decrease as individuals enter older age. Furthermore, it would seem that PTG should not be considered a holistic concept but rather a conglomeration of positive changes. Implications of the findings are discussed within the context of limitations and potential intervening factors.
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Affiliation(s)
- Rahel Bachem
- Bob Shapell School of Social Work and I‐Core Research Center for Mass TraumaTel‐Aviv UniversityTel‐AvivIsrael
| | - Saskia Mitreuter
- Department of Medical Psychology and Medical SociologyUniversity of LeipzigLeipzigGermany
| | - Yafit Levin
- Bob Shapell School of Social Work and I‐Core Research Center for Mass TraumaTel‐Aviv UniversityTel‐AvivIsrael
| | - Jacob Y. Stein
- Bob Shapell School of Social Work and I‐Core Research Center for Mass TraumaTel‐Aviv UniversityTel‐AvivIsrael
| | - Zhou Xiao
- Bob Shapell School of Social Work and I‐Core Research Center for Mass TraumaTel‐Aviv UniversityTel‐AvivIsrael
| | - Zahava Solomon
- Bob Shapell School of Social Work and I‐Core Research Center for Mass TraumaTel‐Aviv UniversityTel‐AvivIsrael
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Villanova Quiroga C, Fritzen Binfaré L, Rudnicki T, Iracema de Lima Argimon I. Rumination and social support as predictors of posttraumatic growth in women with breast cancer: a systematic review. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: Posttraumatic Growth (PTG) is a perceived positive change after a stressful situation. Studies describe different predictors of PTG. The purpose of this study was to (1) review the evidence that rumination and social support are predictors of PTG; (2) analyze the results of the screened studies. Method: A systematic review was conducted by searching for articles with quantitative or mixed methods that evaluated PTG using the Posttraumatic Growth Inventory, rumination and/or social support in women with breast cancer. Results: Were identified twelve articles that corresponded to the inclusion criteria. All of them reported some degree of PTG in their samples. Rumination was evaluated in three studies, social support was evaluated in ten, and both were considered to have a positive correlation with PTG. Conclusions: This review concludes that rumination and social support are predictors of PTG in women with breast cancer. These results contribute to the development of new interventions in mental health.
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Cheng CT, Ho SMY, Hou YC, Lai Y, Wang GL. Constructive, illusory, and distressed posttraumatic growth among survivors of breast cancer: A 7-year growth trajectory study. J Health Psychol 2018; 25:2233-2243. [DOI: 10.1177/1359105318793199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A total of 84 breast cancer survivors completed a package of psychological inventories in 2009 (Time 1), 2012 (Time 2), and 2016 (Time 3). Latent class growth analysis revealed three posttraumatic growth trajectory patterns: distressed posttraumatic growth ( n = 5, 6.7%), illusory posttraumatic growth ( n = 42, 56.0%), and constructive posttraumatic growth ( n = 28, 37.3%). Women with more frequent use of helplessness–hopelessness coping and lower depression levels at Time 1 were more likely to display an illusory than a constructive posttraumatic growth trajectory pattern. Illusory posttraumatic growth might represent a form of coping rather than authentic positive changes. Researchers and clinicians should understand different patterns of posttraumatic growth.
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Affiliation(s)
- Chih-Tao Cheng
- Koo Foundation Sun Yat-Sen Cancer Center, Taiwan
- National Defense University, Taiwan
| | | | - Yi-Chen Hou
- Koo Foundation Sun Yat-Sen Cancer Center, Taiwan
| | | | - Ging-Long Wang
- Koo Foundation Sun Yat-Sen Cancer Center, Taiwan
- National Yang-Ming University, Taiwan
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38
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Bazzi AR, Clark MA, Winter MR, Ozonoff A, Boehmer U. Resilience Among Breast Cancer Survivors of Different Sexual Orientations. LGBT Health 2018; 5:295-302. [PMID: 29878863 DOI: 10.1089/lgbt.2018.0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Resilience could help protect the psychosocial wellbeing of sexual minority women (SMW) experiencing stressors from both breast cancer and sexual minority status; however, little research has assessed resilience among breast cancer survivors of different sexual orientations. METHODS From 2011 to 2012, we surveyed a national sample of breast cancer survivors matched on sexual orientation, age, and cancer status. RESULTS Among heterosexual (n = 339) and sexual minority (n = 201) breast cancer survivors (n = 540 overall), multivariable regression analyses revealed that more social support (coefficient: 0.87; 95% confidence interval [CI]: 0.56-1.19), fighting spirit combined with helplessness/hopelessness (coefficient: 0.30; 95% CI: 0.13-0.47), and fatalism (coefficient: 0.40; 95% CI: 0.14-0.65) were associated with greater resilience. Mental health counseling before breast cancer diagnosis and anxious preoccupation following cancer diagnosis were associated with reduced resilience (coefficient: -2.50; 95% CI: -3.83 to -1.18; and -0.46; 95% CI: -0.60 to -0.32). Although sexual orientation was not independently associated with resilience, among SMW, those who were unemployed had reduced resilience compared with those who were employed (coefficient: -3.52; 95% CI: -5.75 to -1.28), whereas there was no association between employment and resilience among heterosexual women. CONCLUSION These findings suggest that social support and other factors associated with resilience could be leveraged by interventions to improve the health and wellbeing of diverse cancer survivors.
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Affiliation(s)
- Angela R Bazzi
- 1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts
| | - Melissa A Clark
- 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Shrewsbury, Massachusetts
| | - Michael R Winter
- 3 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts
| | - Al Ozonoff
- 4 Center for Patient Safety and Quality Research, Boston Children's Hospital , Boston, Massachusetts.,5 Department of Pediatrics, Harvard Medical School , Boston, Massachusetts
| | - Ulrike Boehmer
- 1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts
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39
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Chen J, Wu X. Posttraumatic Stress Symptoms and Posttraumatic Growth in Children and Adolescents Following an Earthquake: A Latent Transition Analysis. J Trauma Stress 2017; 30:583-592. [PMID: 29244905 DOI: 10.1002/jts.22238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 07/05/2017] [Accepted: 08/10/2017] [Indexed: 11/06/2022]
Abstract
This study examined the transitions in classes of posttraumatic stress symptoms and posttraumatic growth in a sample of children and adolescents (N = 757), between 8 and 20 months after the 2013 Ya'an earthquake in China. Using latent profile analysis, three classes of symptoms (resilient, thriving, and struggling) were identified at 8 and 20 months after the earthquake. Latent transition analysis indicated that the majority of survivors remained in the same class during the period, while others showed a transition between different classes over time. The transition was mainly characterized by three paths: from struggling to resilient, and from thriving to either resilient or struggling. Of the survivors who were classified as thriving at 8 months, those transitioning to the struggling class at 20 months were more likely to experience higher levels of loss and injury compared with those transitioning to the resilient class (Cohen's d = 0.72) or remaining in the thriving class (Cohen's d = 0.36) at 20 months postearthquake. Survivors who remained stable in the struggling class were older than those who remained stable in the thriving class (Cohen's d = 0.41) or those who moved from thriving at 8 months to resilient at 20 months after the earthquake (Cohen's d = 0.39). It is recommended that clinicians consider the classes of posttraumatic stress symptoms and posttraumatic growth, and the potential development paths and associated factors, when implementing interventions for children and adolescents after a natural disaster.
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Affiliation(s)
- Jieling Chen
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
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40
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Zhu L, Ranchor AV, Helgeson VS, van der Lee M, Garssen B, Stewart RE, Sanderman R, Schroevers MJ. Benefit finding trajectories in cancer patients receiving psychological care: Predictors and relations to depressive and anxiety symptoms. Br J Health Psychol 2017; 23:238-252. [DOI: 10.1111/bjhp.12283] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 09/05/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Lei Zhu
- Department of Health Psychology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
- School of Psychology; Shaanxi Normal University; Xi'an China
| | - Adelita V. Ranchor
- Department of Health Psychology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - Vicki S. Helgeson
- Department of Psychology; Carnegie Mellon University; Pittsburgh Pennsylvania USA
| | - Marije van der Lee
- Centre for Psycho-Oncology; Helen Dowling Institute; Bilthoven the Netherlands
| | - Bert Garssen
- Centre for Psycho-Oncology; Helen Dowling Institute; Bilthoven the Netherlands
| | - Roy E. Stewart
- Department of Public Health; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - Robbert Sanderman
- Department of Health Psychology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
- Department of Psychology Health & Technology; University of Twente; Enschede the Netherlands
| | - Maya J. Schroevers
- Department of Health Psychology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
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41
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The trajectory of positive psychological change in a head and neck cancer population. Int J Oral Maxillofac Surg 2017; 47:578-584. [PMID: 29030020 DOI: 10.1016/j.ijom.2017.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/24/2017] [Accepted: 09/20/2017] [Indexed: 11/21/2022]
Abstract
A stressful event may be sufficient to challenge a strongly held set of assumptions about the world and the self. In some people this may lead to post-traumatic stress disorder (PTSD) and in others to positive psychological change (PPC), whereby a person's reactions to the challenge are beneficial. Little research has investigated PPC in people who have had head and neck cancer (HNC). The aim of this study was to identify demographic, clinical, and psychological factors associated with PPC over time. A cross-sequential study collected data over 5 years. Participants were sent the Silver Lining Questionnaire (SLQ; a measure of PPC), the University of Washington HNC quality of life measure, and the Medical Outcomes Short-Form 12 each year. Additional data were collected from clinical records. Analysis using linear mixed-effects modelling revealed that participants with lower stage tumours and those who only had a surgical intervention reported greater PPC over time. Multivariable modelling adjusting for psychosocial variables found that PPC had a quadratic relationship with time since diagnosis, increasing initially and levelling off after 18 months. These findings build on the minimal PPC research with people following HNC. In particular it demonstrates a model of trajectories for the development of PPC longitudinally over time.
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Harding S, Moss TP. The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment. Int J Oral Maxillofac Surg 2017; 47:302-308. [PMID: 28843885 DOI: 10.1016/j.ijom.2017.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/22/2017] [Accepted: 07/31/2017] [Indexed: 11/27/2022]
Abstract
Head and neck cancer carries a high level of morbidity and mortality. So why could anyone find having such a disease a positive event? The adversity hypothesis of "what doesn't kill you makes you stronger" suggests that people can use adversity to develop as human beings. This positive psychological change has received little attention in relation to head and neck cancer. Responses to the Silver Lining Questionnaire, University of Washington Quality of Life Questionnaire, and Short-Form 12 were collected from a postal survey, 3 to 12 months after the completion of treatment for head and neck cancer. Fifty-two (63%) people returned the survey and were included in the analysis. Time since completion of therapy did not show any relationship with positive psychological change. Tumour stage and treatment regimen both had a relationship with positive change. Participants with lower stage tumours had higher levels of positive change than those with tumours of higher stages. Participants who had surgery alone reported more positive change than those who had surgery with radiotherapy. A social factor related to greater change was being married or living with a partner when compared to living alone. Further research would aid the identification of bio-psychosocial factors that influence the development of positive psychological change and inform the development of rehabilitation interventions.
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Affiliation(s)
- S Harding
- Department of Health and Social Sciences, University of the West of England, Bristol, UK.
| | - T P Moss
- Centre for Appearance Research, University of the West of England, Bristol, UK
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43
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Kroemeke A, Bargiel-Matusiewicz K, Kalamarz M. Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation. Front Psychol 2017; 8:1245. [PMID: 28775703 PMCID: PMC5517438 DOI: 10.3389/fpsyg.2017.01245] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/07/2017] [Indexed: 12/23/2022] Open
Abstract
Objectives: Post-traumatic growth (PTG) and its opposite-post-traumatic depreciation (PTD)-may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership. Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied. Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41). Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.
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Affiliation(s)
- Aleksandra Kroemeke
- Department of Psychology, SWPS University of Social Sciences and HumanitiesWarsaw, Poland
| | | | - Magdalena Kalamarz
- Department of Psychology, Faculty in Katowice, SWPS University of Social Sciences and HumanitiesKatowice, Poland
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44
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Jung YM, Park JH. [Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory]. J Korean Acad Nurs 2017; 47:319-331. [PMID: 28706167 DOI: 10.4040/jkan.2017.47.3.319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop a scale to evaluate posttraumatic growth in patients with cancer and to examine the validity and reliability of the scale. METHODS A literature review, semi-structured patient interviews and an expert panel consultation produced a 27 preliminary item questionnaire. Participants were 150 cancer patients recruited to test the reliability and validity of the preliminary scale. Data were analyzed using item analysis, exploratory factor analysis, convergent validity and internal consistency. RESULTS Item reduction and exploratory factor analysis led to 23 items, grouped into five subscales which were labelled new possibilities (6 items), coping skills (5 items), preciousness of life (5 items), relating to others (4 items), and personal strength (3 items). Convergent validity was evaluated by total correlation with the Functional Assessment of Cancer Therapy-General (r=.45, p<.001). The final scale demonstrated satisfactory internal consistency (Cronbach's α =.94). CONCLUSION Findings from this study indicate that the Cancer-Specific Posttraumatic Growth Inventory has validity and reliability and is considered to be appropriate for assessing posttraumatic growth in patients with cancer.
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Affiliation(s)
- Young Mi Jung
- Department of Nursing, College of Health Science, Cheongju University, Cheongju, Korea
| | - Jin Hee Park
- College of Nursing · Institute of Nursing Science, Ajou University, Suwon, Korea.
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45
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Grov EK, Fosså SD, Dahl AA. A controlled study of the influence of comorbidity on activities of daily living in elderly cancer survivors (the HUNT-3 survey). J Geriatr Oncol 2017. [PMID: 28629695 DOI: 10.1016/j.jgo.2017.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To examine the influence of somatic comorbidity on Activity of Daily Living (ADL) problems in cancer survivors ≥70years (ECSs) based on data from The Health Study of Nord-Trøndelag County (HUNT-3) 2006-08. MATERIAL AND METHODS Among participants of the HUNT-3 survey, 599 ECSs had a diagnosis of one invasive cancer according to both The Cancer Registry of Norway and self-report. Three controls without cancer aged ≥70years for each ECS were drawn from the HUNT-3 sample. We compared personal-ADL (P-ADL) and instrumental-ADL (I-ADL) problems for ECSs and differences between ADL problems for ECSs with and without comorbidity and controls with and without comorbidity. RESULTS The prevalence of P-ADL problems was 3.5% among ECSs and 2.9% among controls (p=0.97) and for I-ADL 28.5% versus 21.4% (p=0.01), respectively. In bivariate analyses where ECSs versus controls was the dependent variable, presence of I-ADL problems, higher age, being female, paired relationship, poor self-rated health, hospitalization last year, and low level of neuroticism were associated being ECSs. In multivariate analyses, these variables, except I-ADL-problems and paired relationship, remained significantly associated being ECSs. No significant differences were shown for P-ADL problems when comparing ECSs and controls with comorbidity, and ECSs with and without comorbidity. ECSs with comorbidity reported significantly more I-ADL-problems than controls with comorbidity, and ECSs with comorbidity had significantly more I-ADL-problems than ECSs without comorbidity. CONCLUSION Our results reflect common factors found in ADL studies in the elderly population. Health personnel have to be particularly observant on I-ADL problems among female ECSs, and those reporting poor self-rated health or comorbidity.
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Affiliation(s)
- Ellen Karine Grov
- Oslo and Akershus University College of Applied Sciences, 0130 Oslo, Norway.
| | - Sophie D Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Norwegian Radium Hospital, 0424 Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Norwegian Radium Hospital, 0424 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
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Casellas-Grau A, Ochoa C, Ruini C. Psychological and clinical correlates of posttraumatic growth in cancer: A systematic and critical review. Psychooncology 2017; 26:2007-2018. [PMID: 28317221 DOI: 10.1002/pon.4426] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 02/13/2017] [Accepted: 03/15/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. METHODS A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. RESULTS Seventy-two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross-sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness-related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness-related-life-threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. CONCLUSIONS The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.
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Affiliation(s)
- Anna Casellas-Grau
- Hospital Duran i Reynals. Avinguda de la Gran Via, Institut Català d'Oncologia, Barcelona, Spain
| | - Cristian Ochoa
- Hospital Duran i Reynals. Avinguda de la Gran Via, Institut Català d'Oncologia, Barcelona, Spain.,Facultat de Psicologia. Edifici Ponent - Planta baixa, Universitat de Barcelona, Barcelona, Spain
| | - Chiara Ruini
- Department of Psychology, University of Bologna, Bologna BO, Italy
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Abstract
Compelling evidence suggests that physical activity is an effective intervention
for cancer survivors, including for those undergoing active cancer treatments.
However, to date most evidence has emerged from interventions that have promoted
moderate to vigorous physical activity. In this conceptual review, we argue that
attention should be given to the entire continuum of physical activity from
reducing sedentary behavior to increasing higher levels of physical activity
when possible. In addition, considerable evidence in the cancer literature
supports the value of mindfulness-based interventions as a means of helping
patients and survivors cope with the variety of threats that accompany this
disease. Based on the success of these two areas of research, we argue for
conceptualizing and promoting physical activity as Mindfulness-Based Movement,
using Polyvagal Theory as a theoretical framework to understand the role and
value of Mindfulness-Based Movement as a potential intervention for cancer care
and control.
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Affiliation(s)
| | - Heidi D Klepin
- 1 Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Stephen W Porges
- 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Beck CT, Eaton CM, Gable RK. Vicarious Posttraumatic Growth in Labor and Delivery Nurses. J Obstet Gynecol Neonatal Nurs 2016; 45:801-812. [PMID: 27718368 DOI: 10.1016/j.jogn.2016.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate vicarious posttraumatic growth in labor and delivery nurses who cared for women during traumatic births. DESIGN A convergent parallel mixed-methods design was used. PARTICIPANTS The sample consisted of 467 labor and delivery nurses who completed the quantitative portion and 295 (63%) who completed the qualitative portion of this mixed-methods study via the Internet. METHODS The Association of Women's Health, Obstetric and Neonatal Nurses sent out e-mails to members who were labor and delivery nurses with a link to the electronic survey. Labor and delivery nurses completed the Posttraumatic Growth Inventory and the Core Beliefs Inventory in the quantitative portion. For the qualitative portion, the nurses were asked to describe their experiences of any positive changes in their beliefs or life as a result of their care for women during traumatic births. RESULTS Labor and delivery nurses who cared for women during traumatic births reported a moderate amount of vicarious posttraumatic growth as indicated by their Posttraumatic Growth Inventory scores. Appreciation of Life was the dimension of the Posttraumatic Growth Inventory that reflected the highest growth, followed by Relating to Others, Personal Strength, Spiritual Change, and New Possibilities. In the qualitative findings, Relating to Others was also the dimension of posttraumatic growth most frequently described. CONCLUSION We compared our results with those of previous studies in which researchers assessed vicarious posttraumatic growth in clinicians, and we found that labor and delivery nurses who cared for women during traumatic births experienced growth levels that were scored between the lowest and highest reported levels of therapists and social workers. Nurses need to be aware of the potential to experience this growth despite the significant stress and unpredictability of the labor and delivery environment, which could decrease burnout and improve retention rates.
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