Relationships among hope, meaning in life, and post-traumatic growth in patients with chronic obstructive pulmonary disease: A cross-sectional study

Patterns and predictors of symptom burden and posttraumatic growth among patients with cancer: a latent profile analysis

PURPOSE

The study identified different patterns of symptom burden and posttraumatic growth (PTG) among patients with cancer and to explored the effects of sociodemographic, disease-related, and family resilience factors, which could provide reference for the development of personalized nursing measures.

METHODS

A questionnaire survey was conducted with 329 patients with cancer who were undergoing treatment. Latent profile analysis (LPA) was used to explore the patterns of symptom burden and PTG among patients with cancer, and multiple logistic regression analysis was used to explore the influencing factors of different patterns.

RESULTS

Based on the fit indicators of LPA, a three-class pattern model of posttraumatic responses was shown to be optimal, including resisting, struggling, and growth groups. In the resisting group (34.34%), patients reported low symptom burden and low PTG; in the struggling group (19.15%), patients showed a high symptom burden and moderate PTG; in the growth group (46.51%), patients showed low symptom burden and high PTG. Moreover, patients with cancer with high levels of family resilience were more likely to fall into the struggling and growth groups. Specifically, those with lower scores in the optimistic attitude and higher scores in the family and social support dimension of family resilience were more likely to fall into the struggling group, whereas those with lower scores in the transcendence and spiritual belief dimensions of family resilience were more likely to fall into the resisting group. Additionally, patients with at least three children were more likely to fall into the struggling group.

CONCLUSIONS

This study showed heterogeneity in symptom burden and PTG patterns among patients with cancer. Patients' growth must include both psychological growth and the mitigated symptom burden. Family factors may be intervention targets to improve the growth patterns.

Relationship among post-traumatic growth, spiritual well-being, and perceived social support in Chinese women with gynecological cancer

This study aimed to examine the correlation between post-traumatic growth (PTG), spiritual well-being (SWB), perceived social support (PSS), and demographic and clinical factors in Chinese gynecological cancer patients. Through convenience sampling, we conducted a cross-sectional study of 771 adult patients with gynecological cancer. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Spiritual Well-being 32 (EORTC QLQ-SWB32), Post-traumatic Growth Inventory (PTGI), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure SWB, PTG, and PSS. A Multiple Linear Regression Model was used to determine the possible factors contributing to PTG. The subscale with the highest centesimal score in the PTGI was the Appreciation of Life Scale, and the lowest was New Possibility. Gynecologic cancer patients with younger ages (B =  - 0.313, P = 0.002), perceived more family support (B = 1.289, P < 0.001), had more existential (B = 0.865, P = 0.010), and had religious belief (B = 5.760, P = 0.034) may have more PTG. Spiritual well-being, perceived social support, younger age, and religious beliefs are associated with post-traumatic growth in gynecological cancer patients. Healthcare staff could provide more professional support to younger patients with religious beliefs. Promoting social support and spiritual well-being could potentially serve as effective interventions for boosting PTG among gynecological cancer.

The relationship of social support to posttraumatic growth in COVID-19 among college students after experiencing campus lockdown: the effects of belief in a just world and meaning in life

Background

Campus lockdown orders were issued for the purpose of preventing and controlling COVID-19, which resulted in psychological problems among college students. However, the experiences they have during the pandemic may also lead to positive personal changes, including posttraumatic growth (PTG). The current study examined the mediating role of belief in a just world and meaning in life in social support and PTG during the COVID-19 campus lockdown.

Method

An online survey was conducted on 1711 college students in Hebei Province, China. Based on the survey results, a structural equation model was established.

Results

Social support positively predicted PTG. Furthermore, belief in a just world and meaning in life played a mediating role between social support and PTG respectively. Besides, social support could also predict PTG through the multiple serial mediating effect of belief in a just world and meaning in life.

Conclusion

These results indicated mechanisms by which social support influenced PTG, and this provided insights into how to promote post-traumatic growth among university students in the post-pandemic period.

The Mediator Role of Meaning in Life in the Life Quality of Patients With Chronic Heart Failure

PURPOSE

Heart failure (HF) is a highly recurrent disease with a high sudden death rate and a substantial influence on disease-related quality of life (QOL). Social support, symptom distress, care needs, and meaning in life all have significant impacts on QOL. We hypothesized that meaning in life plays a mediating role in the relationship of social support, symptom distress, and care needs with QOL among patients with chronic HF.

METHODS

Based on cross-sectional analysis, we recruited 186 HF outpatients who completed structured questionnaires for social support, symptom distress, care needs, meaning in life, and QOL. Structural equation modeling was used to analyze the mediating role of meaning in life in the relationship of social support, symptom distress, and care needs with QOL.

RESULTS

The final model showed good model fit. Meaning in life was associated with global QOL (β = 0.18, p = .032). Although symptom distress (β = -0.26, p = .005) and care needs (β = -0.36, p = .021) were negatively associated with global QOL, meaning in life played a partial mediating role between symptom distress and global QOL (β = -0.02, p = .023) and between care needs and global QOL (β = -0.07, p = .030). However, meaning in life played a complete mediating role between social support and global QOL (β = 0.08, p = .047). The model showed that meaning in life, symptom distress, and care needs explained 50% of global QOL.

CONCLUSIONS

In patients with chronic HF, meaning in life played a mediating role in the relationship of social support, symptom distress, and care needs with QOL. Implementing an intervention to enrich meaning in life may help patients manage the issues caused by symptoms and alleviate their unmet needs.

The Impact of Resilience on Post-Traumatic Growth among Nurses in COVID-19-Designated Hospitals: The Mediating Effect of Meaning in Life

This study aimed to confirm the relationship between resilience, meaning in life, and post-traumatic growth (PTG) among nurses during the COVID-19 pandemic. In particular, the mediating effect of meaning in life on the relationship between resilience and PTG was examined. A cross-sectional descriptive research design was used. The participants were 220 nurses at COVID-19-designated hospitals in Seoul. Descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficient analysis, hierarchical regression, and SPSS PROCESS macro (Model 4) were used for data analyses. As a result of the study, resilience and meaning in life each had a significant positive effect on PTG. In addition, the indirect effect of meaning in life was significant, suggesting that meaning in life partially mediated the relationship between resilience and PTG. The results indicate that nurses' resilience directly contributes to the improvement of PTG, and this relationship is further strengthened indirectly through the presence of meaning in life. Therefore, it is suggested that strategies should be developed to enhance resilience and promote a sense of meaning in the profession in order to support the mental health and foster growth among nurses.

Efficacy of meaning-centered group psychotherapy in Chinese patients with cancer: A randomized controlled trial

OBJECTIVES

Meaninglessness is one of the most common psychological problems in cancer patients, which can lead to anxiety, depression and psychological distress, and diminished quality of life. Recent evidence indicates that meaning-centered group psychotherapy (MCGP) effectively enhances the meaning in life among cancer patients. This study aimed to evaluate the impact of MCGP on the meaning in life, post-traumatic growth, psychological distress, and fear of recurrence among Chinese cancer patients with a favorable prognosis.

METHODS

Sixty-six cancer patients were randomly assigned to either the MCGP group (n = 33) or the control group (n = 33). Participants in the MCGP group underwent a 4-week, 8-session MCGP, while those in the control group received usual care. Meaning in life, post-traumatic growth, psychological distress, and fear of recurrence were assessed at both baseline and postintervention to evaluate the impact of the intervention. The intervention outcomes were analyzed using paired t-tests or analysis of covariance, as appropriate.

RESULTS

Patients in the MCGP group demonstrated significant improvements in meaning in life, post-traumatic growth, and fear of recurrence from baseline to postintervention. In comparison to the control group, the MCGP group displayed positive effects on meaning in life and post-traumatic growth following the intervention. However, no significant effects were observed in terms of psychological distress and fear of recurrence.

SIGNIFICANCE OF RESULTS

Our research offers evidence supporting the effectiveness of MCGP in enhancing meaning in life and post-traumatic growth among Chinese cancer patients with a favorable prognosis.

Reconstructing self from the illness: a constructivist grounded theory study of posttraumatic growth in patients with Crohn's disease

BACKGROUND

Some patients with Crohn's disease report posttraumatic growth, which can promote reductions in anxiety and depression, and improve the patient's quality of life. However, the process of posttraumatic growth remains unclear. The objectives of this study were to explore the social-psychological process of posttraumatic growth in patients with Crohn's disease in the context of Chinese culture and construct an interpretive understanding based on the perspectives of patients.

METHODS

This research adopted Charmaz's constructivist grounded theory. Nineteen participants with Crohn's disease were selected by purposive and theoretical sampling from three hospitals in Hangzhou, Zhejiang Province, as well as from the China Crohn's & Colitis Foundation. In-depth interviews were conducted. Data analysis was based on initial, focused and theoretical coding strategies, and methods such as constant comparison and memo writing were adopted. The Consolidated Criteria for Reporting Qualitative Research, a 32-item checklist for interviews and focus groups, was utilised.

RESULTS

An interpretive understanding of posttraumatic growth in patients with Crohn's disease was constructed. The core category was "reconstructing self from the illness", which included the following four categories: "suffering from the illness", "accepting the illness", "dancing with the illness" and "enriching life beyond the illness". However, not every patient reached the last phase. Before patients enter the next stage, they might begin a new cycle by experiencing new suffering or discovering new unacceptable facts about the illness.

CONCLUSIONS

This interpretive understanding reveals a growth process centred on "reconstructing self from the illness". These findings provide knowledge on the process of posttraumatic growth in patients with Crohn's disease within the wider sociocultural context.

Post-traumatic Growth: The Roles of the Sense of Entitlement, Gratitude and hope

People believe that they are entitled to well-being and safety, and their responses to unexpected traumatic events reveal individual differences. Their reactions vary, from feeling blocked and distressed to feeling proactive towards new growth, depending on their personal resources. The current study sought to identify the role of entitlement in explaining post-traumatic growth (PTG) while considering the role of gratitude and hope as personal resources. We used a community-based sample of Israeli adults (n = 182) who reported experiencing a traumatic event during the preceding year. The relationships between PTG and their sense of entitlement, gratitude, and hope were examined. A stepwise multiple hierarchical regression revealed that all the three variables were associated with PTG. However, the effect of hope turned insignificant with the inclusion of sense of entitlement and gratitude in the regression. Sense of entitlement and gratitude were independently associated with PTG. The theoretical contribution of these findings is discussed, as well as their interventional implications and future directions.

Can respondents accurately self-report posttraumatic growth when coached through the required cognitive steps?

BACKGROUND

Coyne and Tennen [(2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39(1), 16-26. https://doi.org/10.1007/s12160-009-9154-z] argue that completing self-reports of posttraumatic growth (PTG) requires four complicated cognitive steps.

DESIGN

We conducted two experiments designed to (1) use mental chronometry (i.e., reaction times on cognitive tasks) to test whether respondents engage in multiple cognitive steps when completing self-reports of PTG, and (2) determine whether coaching participants to take these steps results in a more valid assessment.

METHOD

In Experiment 1, 310 undergraduates were randomly assigned to complete either the Posttraumatic Growth Inventory (PTGI) or Stress-Related Growth Scale (SRGS), and its corresponding current version that requires only one cognitive step. In Experiment 2, 306 undergraduates were randomly assigned to complete either a guided-steps version of the SRGS or the original SRGS.

RESULTS

Experiment 1 indicated a very small difference in completion time for the PTGI, but not the SRGS, in comparison to the current versions, suggesting respondents do not engage in the four required cognitive steps. In Experiment 2, participants reported less PTG when coached to go through the four cognitive steps, but the resulting scores were generally unrelated to measures of convergent and predictive validity.

CONCLUSION

We conclude that individuals cannot accurately report PTG, even when explicitly coached.

Meaning in life, meaning-making and posttraumatic growth in cancer patients: Systematic review and meta-analysis

Introduction

The purpose of this systematic review and meta-analysis is to assess the association between meaning in life (MiL), meaning-making and posttraumatic growth (PTG) in the context of cancer.

Methods

A systematic search was conducted in eighteen electronic databases. The screening and selection process followed the PRISMA guidelines. For the purpose of the meta-analysis, the correlation coefficients between meaning in life and posttraumatic growth were extracted from the included studies. The effect size (r) was calculated using the restricted maximum-likelihood estimator, a random-effects model. Heterogeneity was assessed through the Q statistic, I² index and forest plot, while publication bias was analyzed with the use of the funnel plot and Egger's test.

Results

889 records were considered according to the inclusion criteria. A total of nine articles, published between 2006 and 2021, were included in the systematic review. More than half were published in the last five years. The sample was mostly diagnosed with breast cancer. The meta-analysis included five articles (N = 844) and the results indicate a significant moderate correlation between meaning in life and posttraumatic growth (r = 0.43, 95% IC [0.36, 0.50]).

Discussion

In conclusion, there is a clear association between meaning in life and posttraumatic growth in cancer patients. Future research should explore this relationship further, in order to better assist and guide meaning centered interventions that can potentiate a positive adjustment and possibly growth from the cancer experience.