Existence of benefit finding and posttraumatic growth in people treated for head and neck cancer: a systematic review

Scoping review protocol of post-traumatic growth (PTG) in Korean cancer survivors

INTRODUCTION

Cancer, a life-threatening chronic disease, is the leading cause of death in Korea, accounting for 27% of all deaths in 2020. Due to advancements in medical technology and early detection of cancer in Korea, the 5-year relative survival rate reached 70.7% (2015-2019), highlighting remarkable progress over the past decades. Although cancer has been seen as a traumatic event, cancer survivors also go through a subjective process of self-maturation, which is called post-traumatic growth (PTG). Because research on PTG among Korean cancer survivors has not been systematically synthesised, a scoping review on this topic will provide a better understanding of the positive psychological changes that occur as a patient moves through the illness trajectory of cancer from a Korean cultural perspective. The purpose of this study was to describe the protocol of a scoping review regarding PTG in Korean cancer survivors.

METHODS AND ANALYSIS

The scoping review framework suggested by Arksey and O'Malley and the manual refined by the Joanna Briggs Institute for scoping reviews will be used with the six framework guidelines developed by Levac et al. Searched databases will include Ovid-MEDLINE, PubMed, Embase, CINAHL, Cochrane Library and PsycInfo, as well as Korean databases, examining all articles published between 2012 and 2023 in Korean or English on PTG in Korean cancer survivors. Extracted data will be collated, charted and summarised.

ETHICS AND DISSEMINATION

Because the scoping review methodology undertakes a secondary analysis of collected data from previous research studies, this study does not require ethical approval. The results of this scoping review will be disseminated through presentations at conferences and publication in a scientific journal.

Post-traumatic stress symptoms and benefit finding: a longitudinal study among Italian health workers during the COVID-19 pandemic

PURPOSE

Research has highlighted that the exposure of healthcare professionals to the COVID-19 pandemic for over two years can lead to the development and persistence of symptoms characteristic of Post-Traumatic Stress Disorder (PTSD), with serious consequences on both the individual well-being and the quality of care provided. The present study was aimed at investigating the role of benefit finding in moderating post-traumatic stress symptoms (PTSS) over time.

METHODS

The longitudinal study, conducted between April and October 2020, involved 226 Italian health workers (44.7% nurses and midwives, 35% doctors, 20.3% technical and rehabilitation professionals), who filled out an online survey at the beginning of the study (T1), after three months (T2), and after six months (T3). Participants (77.4% women; mean age = 41.93, SD = 12.06) completed the PTSD Checklist for DSM-5 (PCL-5) and Benefit Finding, a 17-item questionnaire measuring the perceived level of positive consequences derived from stressful experiences. A hierarchical regression analysis highlighted the moderating effect of benefit finding (T2) on the association between PTSS values at T1 and T3.

RESULTS

A buffering effect was observed, with higher benefit finding levels reducing the magnitude of the bivariate association between PTSS assessed at the beginning and at the end of the study.

CONCLUSION

Findings suggest the potential mental health related benefits of interventions allowing health professionals to identify positive aspects in the experience of working under prolonged emergency circumstances, such as the pandemic ones.

The effect of post-traumatic growth on recovery in liver transplant recipients

Aim

In our study, we examined the effect of post-traumatic growth on recovery in liver transplant recipients in the post-transplant period.

Method

This research was performed as a descriptive and cross-sectional study with the participation of 218 patients who had liver transplantation at the liver transplant institute of a research and training hospital. The personal information form, the Post-Traumatic Growth Inventory, and the Recovery Assessment Scale were used in the data collection process. The Statistical Package for Social Science 25.0 was utilized in the data analysis process.

Findings

In the research, of all participant liver transplant recipients, 67.8% were aged 45-64 years, 34.4% had incomes below expenses, and 91.7% had living donor liver transplantation. Besides, it was found that participants who had living donor liver transplantation obtained higher mean scores from both the Post-Traumatic Growth Inventory and the Recovery Assessment Scale than participants who had cadaveric donor liver transplantation, and likewise, participants who had past surgery experiences obtained higher mean scores from both the Post-Traumatic Growth Inventory and the Recovery Assessment Scale than participants who had no past surgery experience (p < 0.05). Moreover, there was a statistically significant positive linear relationship between participant liver transplant recipients' Post-Traumatic Growth Inventory and Recovery Assessment Scale scores.

Conclusion

Post-traumatic growth supports recovery. Also, social support and a good economic situation are other parameters that promote recovery. In the two-year process during which the treatment is intensively applied to liver transplant recipients following the transplantation surgery, it is important to enable patients to find more meaning in life and to find solutions that facilitate recovery.

Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination, a cross-sectional study

Background

Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined.

Methods

The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model.

Results

The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=-0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=-0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients.

Conclusions

The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

Community Post-traumatic Growth: Israeli Ultra-Orthodox Coping with Coronavirus

The present study sheds light on the phenomenon whereby groups experience adversity, following which they show signs of growth. We propose the conceptualization of post-traumatic growth as a phenomenon that also exists at the group level, “community post-traumatic growth” (CPTG). The concept of CPTG is explained using a case study on the ultra-Orthodox Jewish community in Israel following the first wave of the coronavirus disease 2019 (COVID-19) pandemic. The study describes shared characteristics of Israeli ultra-Orthodox society and the crisis it experienced during the first wave of the COVID-19 pandemic, both in terms of physiological features such as the relatively high proportion of affected people and in terms of psychological characteristics such as the shut-down of synagogues and yeshivas, and the perceived discrimination they experienced from the general population in Israel. The present study views the sense of discrimination as a traumatic factor at the group level. In total, 256 participants completed online questionnaires examining three hypotheses: (1) sense of discrimination (trauma) will be correlated with level of CPTG; (2) the level of identification with the ultra-Orthodox culture will be positively related to CPTG, while the level of identification with Israeli culture will be negatively correlated with CPTG; (3) the level of life satisfaction of the individual will be predicted by CPTG. The results supported the hypotheses and are discussed at length in the discussion section.

Benefit finding: understanding the impact and public health factors among COVID-19 patients in China

BACKGROUND

This study aimed to determine the level of benefit finding among COVID-19 patients in a hospital in mainland China, and to identify its associated impact and public health factors.

METHODS

Using a cross-sectional design, a total of 288 COVID-19 patients were recruited in Huoshenshan Hospital in Wuhan, China to complete a survey on benefit finding. The level of benefit finding evaluated by the Benefit Finding Scale (BFS), mental resilience evaluated by the Connor-Davidson Resilience Scale (CD-RISC), social support evaluated by the Multidimensional Scale of Perceived Social Support (MSPSS), medical coping modes evaluated by the Medical Coping Modes Questionnaire (MCMQ), and general information was collected by self-designed questionnaires. T-test and chi-square test were used for single-factor analyses. For multiple factor analyses, multivariate regression analyses were performed.

RESULT

The mean BFS score of 288 participants was 61.26±10.25. Multivariate regression analysis showed that the factors associated with the level of benefit finding among COVID-19 patients in China included education level, having experienced major event, social support, optimism, confrontive coping and resigned coping mode.

CONCLUSIONS

In general, the patients with COVID-19 in this study had a middle level of benefit finding. Health professionals should take measures to identify the influencing factors on the quality of the life and take targeted intervention measures.

Transitioning the eating experience in survivors of head and neck cancer

PURPOSE

Applying the Social Cognitive Transition (SCT) Model of Adjustment as an interpretive framework, this mixed-methods case series explored how head and neck cancer (HNC) survivors participate in the dimensions of the eating experience (described as physiological, psychological, social, cultural).

METHODS

This was a sub-study of a primary study, "The Natural History and Impact of Taste Change in Oncology Care." Qualitative interviews and quantitative data (questionnaires and exams) were intersected to examine and describe the complexities of transitioning the eating experience after treatment for HNC. Triangulation of qualitative and quantitative data within and across cases was examined to produce rich descriptions of the changes and transitions in the eating experience.

RESULTS

Four case studies were detailed. All reported some taste and/or smell changes. Each case described worry about weight loss and the decreased ability to engage and finding meaning in the eating experience. Each expressed coping strategies that drew upon the social and cultural dimensions of their prior eating experience that brought meaning and purpose to the post-treatment eating experience.

CONCLUSIONS

This case series explored the impact of taste and oral function and the participant's pre- and post-treatment mental model of the eating experience. Application of the SCT Model of Adjustment to the eating experience in adults with HNC provided a deeper insight into how cognitive adaptation and coping strategies supported transition in identity related to the eating experience following cancer therapy.

Posttraumatic Growth in Postlingually Deaf Patients With Cochlear Implants: The Effect of Stress-Coping Strategies, Sociodemographics, and Deafness-Related Factors

The aim of this study was to assess whether cochlear implant (CI) users who had been postlingually deaf developed a more positive outlook on life—the so-called posttraumatic growth (PTG)—as a result of their disability and to examine how PTG related to their stress-coping strategies and personal circumstances. The study group consisted of 119 postlingually deaf CI users. The participants were asked to anonymously fill in several questionnaires: the Post-Traumatic Growth Inventory (PTGI), Coping Orientations to Problems Experienced (Brief COPE), and a form asking for personal details and factors related to their deafness and CI use. The PTG of postlingually deaf CI users was similar to that found in people with other severe health problems. The time that had elapsed since the hearing was lost and the time from receiving a CI were positively correlated with PTG. The level of PTG was correlated with the particular coping strategies used and differed between men and women. We found that the development of PTG could emerge from both approach-oriented coping strategies (e.g., active coping and planning) and avoidance-oriented coping strategies (e.g., denial, self-distraction, and self-blame). Paradoxically, the avoidance strategies could play a positive role in the development of PTG. This reinforces the idea, previously raised in the PTG literature, that such strategies exert a defensive and protective function—an “illusory” side of PTG—which operates together with the positive constructive side, and both help develop the sense of well-being of a person.

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

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

Otimismo e ganho percebido em cuidadores de crianças com câncer

Com o objetivo de analisar as relações entre otimismo e ganho percebido em cuidadores de crianças com câncer, constituiu-se uma amostra de conveniência de 60 cuidadores, com média de idade de 36,5 anos (DP=9,17), 81,7% de mulheres, em um hospital de referência. Utilizaram-se os instrumentos: Teste de Orientação da Vida, Inventário de Desenvolvimento Pós-Traumático, e questionário sociodemográfico e clínico. Após análise estatística descritiva e inferencial, verificou-se correlação positiva entre otimismo e ganho percebido (percepção de recursos e competências pessoais). Otimismo e ganho percebido também se associaram às variáveis clínicas e sociodemográficas: cuidadores casados e com crianças fora de quimioterapia referiram maior ganho percebido; e cuidadores cujos filhos tinham mais tempo de tratamento, se mostraram mais otimistas e com maior ganho percebido. Conclui-se que características individuais e clínicas devem ser consideradas em intervenções com foco na ressignificação da experiência de ter um filho com câncer e o crescimento frente à adversidade.

Measuring positive psychosocial sequelae in patients with advanced cancer

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

A randomized controlled trial of a guided self-disclosure intervention to facilitate benefit finding in Chinese breast cancer patients: Study protocol

AIM

To describe a protocol that examines the feasibility and effectiveness of a face-to-face guided self-disclosure intervention for facilitating benefit finding and other related psychological outcomes for breast cancer patients.

BACKGROUND

Benefit finding can promote a positive attitude among patients facing disease. However, limited studies have focused on improving benefit finding among breast cancer patients. Previous research has been based on group interventions, which may not suit all patients. Self-disclosure was recognized as a strong predictor of benefit finding. This protocol is based on a brief face-to-face disclosure intervention to improve benefit finding for breast cancer patients.

DESIGN

A non-blinded randomized controlled trial.

METHODS

A total of 154 patients with breast cancer who have undergone radical mastectomy will be randomly assigned to either the experimental group, which will participate in a six-session face-to-face individual intervention, or the control group at a ratio of 1:1. Baseline assessments will take place after the breast cancer diagnosis, with follow-up assessments at 3, 6 and 9 months after baseline. The primary outcome is benefit finding; other outcomes are self-disclosure, cognitive reappraisal, social support, optimism and medical coping modes.

DISCUSSION

This study is to design a protocol for guided self-disclosure interventions to promote benefit finding in Chinese breast cancer patients. If this intervention is feasible and effective, it could be implemented in clinical practice.

IMPACT

This study will provide useful advice for health professionals to guide breast cancer patients in benefit finding during stressful events. If it is effective, it will be implemented broadly in clinical practice.

Diagnosis of cancer is not a death sentence: Examining posttraumatic growth and its associated factors in cancer patients

Objectives: Posttraumatic growth (PTG) is the experience of positive psychological growth as a result of struggle with highly challenging life crises. This study was conducted to investigate the degree of PTG and its associated factors, as well as to identify which positive psychological parameters most significantly associated with greater PTG among Malaysian cancer patients. Design, sample, & methods: This cross-sectional survey included 195 patients with different cancer diagnoses. Perceived spousal support, level of hope, level of optimism, and PTG were measured using various validated indexes. Findings: The total mean score for PTG Inventory-Short Form (PTGI-SF) was 39.87 (±9.09). Female gender, Islamic religious belief, and having higher level of hope and greater spousal support were associated with a higher PTGI-SF score, and the most significant predictor was the hope scale. Conclusions: Malaysian cancer patients exhibited a high level of PTG, and hope was the positive psychological factor which was most significantly associated with PTG. Implications for psychosocial providers: Psychosocial interventions that promote positive psychology should be included in the treatment for cancer patients.

The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis

BACKGROUND

Posttraumatic growth (PTG) is positive psychological changes after encountering challenging events. The main purpose of this meta-analysis was to summarize the prevalence of moderate-to-high PTG in people who experienced traumatic events and to understand what social-demographic and trauma characteristics distinguish those who show a high rate of PTG from those of low level.

METHODS

Six electronic databases were searched. Loney's appraisal criteria were used to evaluate the quality of studies. Freeman-Turkey double arcsine transformation method was used to calculate the combined prevalence. Age, time since event, type of trauma and trauma form were analyzed as subgroup factors. According to the source of the trauma, the type of trauma was divided into three different categories: disease, accident and specific profession. Specific profession refers to firefighters, veterans, intensive care staff, etc. The complex working environment, irregular lifestyle, various unpredictable factors, as well as the frequently adverse stimuli from others contribute to great physical and mental pressure.

RESULTS

Twenty-six articles were deemed as qualified for this systematic review and meta-analysis. The level of PTG across studies ranged from 10% to 77.3%, and heterogeneity tests showed high heterogeneity (I²= 92.3%, 95%CI = 90.1%-94.0%, p < 0.01). Random effect model was chosen to calculate the combined prevalence and the prevalence was 52.58% (95%CI = 48.66%-56.48%). People whose age was younger than 60,had shorter time since trauma,worked in a specific profession and suffered from direct trauma reported high rate of moderate-to-high PTG.

LIMITATIONS

Because the included studies haven't provided adequate PTG-related information, these factors could not be used to performed subgroup analyses. In addition, some studies were excluded due to the different standard may lead to deviation of the combined prevalence.

CONCLUSIONS

Nearly half of the investigated individuals reported moderate-to-high PTG after experiencing a traumatic event. Future research needs to further study the determinants of PTG to provide relevant interventions for the victims of trauma.

"It's Brought Me a Lot Closer to Who I Am": A Mixed Methods Study of Posttraumatic Growth and Positive Change Following a First Episode of Psychosis

Background: A first episode of psychosis is often a traumatic experience that may also lead to positive change, a phenomenon that has received little attention. This knowledge gap may impede service providers' capacity to foster positive change among service users. Objective: To investigate aspects of positive change among persons receiving early intervention services for psychosis. Design: The study objective was addressed using a mixed methods convergent design, which entailed simultaneously employing qualitative and quantitative methods. Setting: This study was conducted at a specialized early intervention service for psychosis based in Montreal, Quebec, Canada. Participants: Participants included service users receiving services at an early intervention service for psychosis. Participants had to be fluent in English or French, be clinically stable enough to take part in the study, and have received at least 6 months of treatment. Participants were conveniently sampled in the quantitative component and purposefully sampled in the qualitative component. The quantitative component was carried out using a cross-sectional survey design. Ninety-four participants completed the Posttraumatic Growth Inventory, a widely used measure of positive change. Data on the extent and domains of posttraumatic growth were summarized using descriptive statistics. The qualitative component was carried out using a qualitative descriptive approach. Semistructured interviews were conducted with 12 participants. Data were analyzed using thematic analysis. Findings from both components were integrated using a weaving method in the discussion section. Results: Quantitative results indicated that most participants reported a moderate amounts of posttraumatic growth. A greater appreciation of life was the most commonly endorsed domain, whereas spiritual growth was the least commonly endorsed domain. The qualitative results revealed that in addition to suffering, participants experienced positive changes, such as improved health and personality, and a stronger sense of self; stronger, more balanced religiosity and spirituality; improved relationships with others; and improved lifestyles, goals, and expectations for the future. Conclusions: Positive change may be a common phenomenon in the aftermath of first episode psychosis. The study findings may provide hope to those who have experienced a first episode of psychosis and can inform efforts by early intervention services to provide recovery-oriented, growth-focused care.

Differential expression of hsa-miR-221, hsa-miR-21, hsa-miR-135b, and hsa-miR-29c suggests a field effect in oral cancer

BACKGROUND

The theory of field effect suggests that the tumor-adjacent area, besides histopathologically normal, undergoes genetic and epigenetic changes that can eventually affect epithelial homeostasis, predisposing the patient to cancer development. One of the many molecular changes described in cancer are microRNAs (miRNAs), which regulates the expression of important genes during carcinogenesis. Thus, the aim of this study was to investigate the field effect in oral cancer.

METHODS

We investigated the differential expression profile of four miRNAs (hsa-miR-221, hsa-miR-21, hsa-miR-135b, and hsa-miR-29c) in cancerous oral tissue, in tumor-adjacent tissue and and in non-cancerous tissue samples from healthy volunteers.

RESULTS

Our results showed significant overexpression profiles of all four studied miRNAs in cancerous oral tissue compared to non-cancerous samples, as well as in tumor-adjacent tissue compared to cancer-free tissue. No significant difference was found when comparing the expression profile of cancerous and tissue-adjacent tissue groups. We found a negative correlation between the expression of hsa-miR-21 expression and STAT3 in oral squamous cell carcinoma.

CONCLUSION

These results suggest that the tissue adjacent to cancer cannot be considered a normal tissue because its molecular aspects are significantly altered. Our data corroborates the hypothesis of field cancerization.

Learning about the experience of living with chronic conditions: A framework analysis of nursing students' reflections on their conversations with older adults

Preparing nursing students to work effectively with older adults is an important element of undergraduate nursing education. Reflective journals written as course assignments represent a source of data about students' learning. The aim of this study was to analyze nursing students' reflective journals based on conversations with older adults who are community dwelling, to identify learning in relation to experiences of living with a chronic condition. This was one element of a wider study to evaluate learning partnerships between older adults who are community dwelling and nursing students as an alternative to traditional clinical placements in long-term care settings. Nursing students worked with faculty to complete a qualitative secondary analysis of 47 journals utilizing framework analysis. Students learned about three main aspects of living with chronic conditions: beliefs about chronic conditions, managing chronic conditions, and experiencing chronic conditions, with some evidence that these themes may be interconnected. Findings suggest that learning partnerships with older adults combined with reflective journaling enable nursing students to understand the experience of chronic conditions in later life as reflected within current literature and to identify interventions for gerontological nursing practice. Enabling nursing students to recognize the highly skilled nature of working with older adults with chronic illness has the potential to influence their future career choices.

The trajectory of positive psychological change in a head and neck cancer population

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.

The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment

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.

Correlates of the positive psychological byproducts of cancer: Role of family caregivers and informational support

Objective:

Experiencing a life-threatening illness such as cancer can elicit both negative (e.g., distress) and positive (e.g., growth) psychological responses. The present study sought to determine the correlates of four positive psychological byproducts in cancer survivors: becoming a stronger person, coping better with life's challenges, making positive changes in life, and adopting healthier habits.

Method:

Data for this cross-sectional study were taken from the Medical Expenditures Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (Yabroff et al., 2012). Cancer survivors (N = 785) reported their sociodemographic and cancer-related characteristics. Descriptive statistics were utilized to summarize cancer survivor characteristics, including demographic factors, cancer factors, and stressors and resources related to cancer. Multivariable logistic regressions were employed to assess the independent association of the stressors and resources with each psychological response, controlling for covariates. All analyses were weighted to account for the complex sampling design of the MEPS.

Results:

In multivariable analyses, those with a family caregiver were 50% more likely to report better coping with challenges, and around 70% were more likely to report making positive changes in life or adopting healthier habits because of their cancer. Receiving informational support from healthcare providers was also consistently associated with positive byproducts (odds ratios ranging from 1.6 to 2.0). Few of the stressors were associated with positive byproducts: having insurance problems due to cancer was positively associated with becoming a stronger person, and work limitations were associated with making positive changes in life; those who reported high perceived chances of recurrence were less likely to report becoming a stronger person.

Significance of Results:

Having a family caregiver and receiving detailed informational support from healthcare providers were associated with reporting positive experiences with cancer. The hypotheses and future research stimulated by these findings may improve our understanding of the process by which positive byproducts develop and may ultimately help improve psychological well-being among cancer survivors.

Quality of life trajectories after diagnosis of gynecologic cancer: a theoretically based approach

PURPOSE

The course of quality of life after diagnosis of gynecologic cancer is not well understood. We aimed to identify subgroups of gynecologic cancer patients with distinct trajectories of quality of life outcomes in the 18-month period after diagnosis. We also aimed to determine whether these subgroups could be distinguished by predictors derived from Social-Cognitive Processing Theory.

METHODS

Gynecologic cancer patients randomized to usual care as part of a psychological intervention trial (NCT01951807) reported on depressed mood, quality of life, and physical impairment soon after diagnosis and at five additional assessments ending 18 months after baseline. Clinical, demographic, and psychosocial predictors were assessed at baseline, and additional clinical factors were assessed between 6 and 18 months after baseline.

RESULTS

A two-group growth mixture model provided the best and most interpretable fit to the data for all three outcomes. One class revealed subclinical and improving scores for mood, quality of life, and physical function across 18 months. A second class represented approximately 12 % of patients with persisting depression, diminished quality of life, and greater physical disability. Membership of this high-risk subgroup was associated with holding back concerns, more intrusive thoughts, and use of pain medications at the baseline assessment (ps < .05).

CONCLUSIONS

Trajectories of quality of life outcomes were identified in the 18-month period after diagnosis of gynecologic cancer. Potentially modifiable psychosocial risk factors were identified that can have implications for preventing quality of life disruptions and treating impaired quality of life in future research.

Quality of Life and Mortality of Long-Term Colorectal Cancer Survivors in the Seattle Colorectal Cancer Family Registry

BACKGROUND AND AIM

Because most colorectal cancer patients survive beyond five years, understanding quality of life among these long-term survivors is essential to providing comprehensive survivor care. We sought to identify personal characteristics associated with reported quality of life in colorectal cancer survivors, and sub-groups of survivors potentially vulnerable to very low quality of life.

METHODS

We assessed quality of life using the Veterans RAND 12-item Health Survey within a population-based sample of 1,021 colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry, approximately 5 years post-diagnosis. In this case-only study, mean physical component summary scores and mental component summary scores were examined with linear regression. To identify survivors with substantially reduced ability to complete daily tasks, logistic regression was used to estimate odds ratios for "very low" summary scores, defined as a score in the lowest decile of the reference US population. All cases were followed for vital status following QoL assessment, and mortality was analyzed with Cox proportional hazards regression.

RESULTS

Lower mean physical component summary score was associated with older age, female sex, obesity, smoking, and diabetes or other co-morbidity; lower mean mental component summary score was associated with younger age and female sex. Higher odds of very low physical component summary score was associated with older age, obesity, less education, smoking, co-morbidities, and later stage at diagnosis; smoking was associated with higher odds of very low mental component summary score. A very low physical component score was associated with higher risk of mortality (hazard ratio (95% confidence interval): 3.97 (2.95-5.34)).

CONCLUSIONS

Our results suggest that identifiable sub-groups of survivors are vulnerable to very low physical components of quality of life, decrements that may represent meaningful impairment in completing everyday tasks and are associated with higher risk of death.

Psychological Transformation by an Intervention to Facilitate Benefit Finding Among People With Chronic Mental Illness in Japan

PURPOSE

This study aimed to preliminarily explore the psychological transformation effected by a newly developed intervention program for facilitating benefit finding among individuals with chronic mental illness in Japan.

DESIGN AND METHODS

An intervention study with three weekly group sessions was implemented, and qualitative data on the participants' experience of benefit finding were obtained by a questionnaire survey and analyzed using content analysis technique.

FINDINGS

Of the 31 participants, 23 responded that they realized some sort of benefit finding through the intervention.

PRACTICE IMPLICATIONS

The program component in question may contribute to enhanced benefit finding for people with chronic mental illness while longitudinal studies involving more participants are desirable.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature

PURPOSE

This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability.

METHODS

Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment.

CONCLUSION

The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers.

Posttraumatic growth among head and neck cancer survivors with psychological distress

BACKGROUND

Information on posttraumatic growth (PTG) among head and neck cancer (HNC) survivors with a high level of distress is limited. The aim of this cross-sectional study was to investigate the occurrence of PTG among distressed HNC survivors and its association with anxiety, depressive, nicotine, and alcohol use disorders and health-related quality of life.

METHODS

Seventy-four HNC survivors with psychological distress (Hospital Anxiety and Depression Scale (HADS) anxiety > 7 and/or HADS depression > 7) completed the Posttraumatic Growth Inventory, which comprises five subscales: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Anxiety, depressive, nicotine, and alcohol use disorders were measured using the Composite International Diagnostic Interview.

RESULTS

Moderate to high Posttraumatic Growth Inventory (PTGI) scores occurred in 10% of the HNC survivors with distress. The mean total PTGI score was 30.8 (SD = 19.7), with the highest mean score on the subscale relating to others. A multivariate regression model consisting of tumor stage, anxiety disorder, alcohol use disorder, and social functioning predicted total PTGI score best (F(4, 64) = 7.565, p < .000, R²  = .321).

CONCLUSIONS

The presence of PTG in this population of distressed HNC survivors was low. PTG occurred most in the domain of relating to others. Among distressed HNC survivors, higher PTG was associated with lower tumor stage, absence of an anxiety disorder, absence of an alcohol use disorder, and better social functioning. Copyright © 2016 John Wiley & Sons, Ltd.