Mechanisms of psychosocial correlates on posttraumatic growth patients with gastrointestinal cancer: A cross-sectional survey of patient-caregiver dyads.

Cancer is one of the leading causes of mortality in the world which imposes numerous psychological burdens on the patients. Psycho-spiritual interventions such as meaning-based therapies may help decrease these challenges. This systematic review and meta-analysis aim to investigate the effects of meaning-based psychotherapy on post-traumatic growth and death anxiety of patients with cancer. PubMed, Scopus, Proquest, Web of Science, and Google Scholar were searched until 30 September 2023. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by STATA software version 17. A total of 17 studies were included in the systematic review. Eleven articles examined the impact of meaning-based interventions on death anxiety and six articles examined post-traumatic growth in cancer patients. Ten studies with a total of 555 participants were included for analysis of the effect of logotherapy versus routine care on death anxiety. Analysis showed a significant decrease effect of logotherapy versus routine care on death anxiety (SMD, - 4.05 (- 6.20, - 1.90); I2, 98.38%). Three studies with a total of 364 participants were included for analysis of the effect of logotherapy versus routine care on post-traumatic growth in patients with cancer. Analysis showed a positive but non-significant effect of logotherapy versus routine care on post-traumatic growth (SMD, 2.05 (- 0.91, 5.01); I2, 99.08%). The qualitative analysis showed the positive impact of meaning-based psychotherapy interventions on death anxiety and post-traumatic growth in cancer patients, but the results of the meta-analysis on post-traumatic growth were not statistically significant. The review shows the need for more clinical trial studies in larger and more diverse samples in terms of cancer types and cultural background.

ABSTRACTCancer has different psychological and physical outcomes. The present study was conducted to examine psychological distress, posttraumatic growth, and dispositional mindfulness in cancer patients. A total of 109 cancer patients entered the research. The Five-Facet Mindfulness Questionnaire (FFMQ), the Depression Anxiety Stress Scales (DASS-21), and the Posttraumatic Growth Inventory (PTGI) were used for data collection. The regression analysis revealed that dispositional mindfulness can be a significant predictor of psychological distress and posttraumatic growth in cancer patients. The results also showed that mindfulness is related significantly to psychological outcomes and adaptation in cancer patients and should be further addressed in cancer treatment.

Post-traumatic growth in cancer patients refers to perceived positive changes following cancer diagnosis and treatment. Little is known about the status and factors related to posttraumatic growth among Chinese patients with lung cancer.To investigate the status and factors of posttraumatic growth among Chinese patients with lung cancer.A cross-sectional design was adopted in this study. Patients (N = 173) from the oncology unit at one teaching hospital in Sichuan were recruited. Posttraumatic growth, depression, anxiety, and coping style were self-reported by the patients. Multiple linear regression analysis was to examine factors related to posttraumatic growth.Posttraumatic growth was a common exit in Chinese lung cancer patients. Time since cancer diagnosis, patient depression, and coping strategies are factors that affect the experience of posttraumatic growth.Reducing depression, providing available support, and improving active coping strategies are areas to facilitate posttraumatic growth.

This longitudinal waitlist-controlled study evaluated the effects of Mindfulness-Based Stress Reduction (MBSR) on spirituality, posttraumatic growth (PTG), and mindfulness in cancer patients. The study also assessed whether increased mindfulness mediated the effects of MBSR on spirituality and PTG. Patients were either registered for immediate participation in MBSR (n = 135), or were naturally waiting for the next program (n = 76). Participants completed questionnaires pre-, mid-, and post-MBSR, or waiting period. Hierarchical linear modeling (HLM) was employed to assess changes over time as a function of condition (MBSR vs. waitlist). Mediation was tested using linear regression and bootstrapping. MBSR participants demonstrated increased spirituality, PTG, and mindfulness, relative to controls. Change in all mindfulness facets mediated the effect of MBSR on spirituality and PTG. The development of mindfulness skills through MBSR may facilitate a sense of meaning, peacefulness, connectedness, and personal growth in cancer patients. This investigation contributes to an emerging focus on determining ‘how’ mindfulness-based interventions work.

The objectives of this study were to investigate self-efficacy and its relationship with posttraumatic stress symptoms and growth in advanced cancer patients. The General Perceived Self Efficacy Scale (GSE), the Greek version of the Impact of Event Scale (IES-Gr), and the Greek version of the Posttraumatic Growth Inventory (PTGI-Gr) were completed by 115 patients. Statistically significant associations were found between GSE score, patients' performance status, intrusions, hyperarousal, and PTGI-Gr score. The multiple regression analysis revealed that self-efficacy was influenced by intrusions and PTGI-Gr score. In advanced cancer patients, factors that seem to influence self-efficacy are intrusion and posttraumatic growth.

The challenge of a cancer diagnosis may eventually lead to the experience of positive psychological changes, also referred to as posttraumatic growth. As most research on posttraumatic growth in cancer patients has been conducted in Western countries, little is known about the experience of such positive psychological changes in non-Western countries. Therefore, the purpose of this cross-sectional study was to investigate the prevalence of posttraumatic growth in a Malaysian sample of cancer patients. Secondly, we examined the association of posttraumatic growth with patients' report of psychological distress and their use of coping strategies. The study was conducted in 113 cancer patients. Posttraumatic growth was measured by the Posttraumatic Growth Inventory, coping strategies by the brief COPE, and psychological distress by the Symptom Check List (SCL-90-R). Results showed that many patients reported posttraumatic growth, mostly in the domain of appreciation of life. As hypothesized, the experience of posttraumatic growth was not significantly related to the level of psychological distress. Findings indicated that greater use of the coping strategies instrumental support, positive reframing, and humor was associated with more posttraumatic growth. Overall, this study suggests that posttraumatic growth is not only a Western phenomenon. Malaysian cancer patients show similar trends in the report of growth as well as in its correlates as their Western counterparts.

Research on the relationship between post-traumatic stress disorder (PTSD)/post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in cancer patients and survivors is increasing. We conducted a systematic review and meta-analysis of 51 studies that assessed the relationship between PTSD/PTSS and PTG, in cancer patients/survivors. Five databases were searched through 29 April 2019. The purpose of this manuscript is to report a summary of this literature, the aggregate effect size of the relationship between PTSD and PTG, and the examination of potential moderators that may impact the relationship between PTSD and PTG. The aggregate weighted effect size for the association between PTSD/PTSS and PTG was small, r = .08, but significantly different from zero. We examined whether time since diagnosis, stage of cancer, type of measure used to assess PTSD/PTSS, or type of measure used to assess PTG explained the significant heterogeneity among the individual effect sizes. The relationship was significantly stronger for the small subset of studies that included only stage 4 patients compared with those that included only non-stage 4 patients. Additionally, the strongest relationship was for those studies that used the Impact of Events Scale-Revised to assess PTSD. The relationship between PTSD/PTSD and PTG is modestly positive and robust. There is evidence that the threat of advanced cancer is more strongly associated with growth, but none supporting that more time since cancer diagnosis allows survivors the opportunity to positively reinterpret and find meaning in the traumatic aspects of the disease resulting in more growth.

IntroductionThis study aims to address the positive changes due to traumatic experiences, such as being diagnosed with cancer and experiencing this disease for a certain period. Within this purpose, socio-demographic and disease-related variables, coping ways and illness perceptions that affect posttraumatic growth in cancer patients were examined. Secondly, the findings of this study, which is one of the first studies on posttraumatic growth in cancer patients in Turkey, were compared with the findings of current studies on the subject.MethodDatums were collected by an interview form and three scales (Posttraumatic Growth Scale, Ways of Coping Inventory and Illness Perception Scale-R) to 78 cancer outpatients in Istanbul University Oncology Institute in 2007.ResultsResults showed that cancer patients have higher posttraumatic growth levels than the mean. According to analysis, posttraumatic growth total score between confrontive coping (t = −2.344, p < 0.05), self-controlling (t = −3.704, p < 0.001), accepting responsibility (t = −3.032, p < 0.01), escape-avoidance (t = −2.285, p < 0.05), planful problem solving (t = −2.502, p < 0.05), positive reappraisal (t = −5.241, p < 0.001), and seeking social support (t = −3.527, p < 0.01) has relationship. Also, there is a relation between posttraumatic growth subscales and the Revised form of Illness Perception Questionnaire; Change in relationships with others subscale (t = 2.887, p < 0.01) and Change in self-perception subscale (t = 2.660, p < 0.01) between timeline (acute/chronic), Change in self-perception subscale between timeline (cyclical) (t = −2.788, p < 0.01) and uncontrollable body factors (t = −1.916, p < 0.05) Change in philosophy of life subscale between external attributions (t = −2.057, p < 0.05) and Change in relationships with others subscale (t = −2.920, p < 0.01) between chance factors. It was found that positive reappraisal (F = 78.290, p < 0.001), self-controlling (F = 39.814, p < 0.001), and distancing (F = 46.311, p < 0.001) were significant predictors of posttraumatic growth total score. Results showed that ways of coping and illness perceptions were essential variables in posttraumatic growth.DiscussionStudies on posttraumatic growth in Turkey and the world have significantly increased in recent years. This study aimed to examine the findings obtained from cancer patients in 2007 in discussion with the findings in the current literature. In this context, it is seen that the relevant variables affecting posttraumatic growth in cancer patients in different cultures do not change.

ObjectiveThis study aimed to investigate the dyadic relationship between illness perception, emotion regulation strategies, and posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers.MethodsThis study used a cross‐sectional approach to collect data from 332 pairs of lung cancer patients receiving chemotherapy and family caregivers from China. Participants completed the Brief Illness Perception Questionnaire, the Emotion Regulation Questionnaire, and the Posttraumatic Growth Inventory. The actor–partner interdependence effects were used to analyze how illness perception and emotion regulation strategies affect posttraumatic growth in the patients themselves and their family caregivers.ResultsBoth illness perception and emotion regulation strategies had significant actor and partner effects on posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Emotion regulation strategies were categorized as cognitive reappraisal and expressive suppression, and patients had lower scores than caregivers for posttraumatic growth, illness perception, and expressive suppression, except for cognitive reappraisal scores, which were higher than caregivers. In patient–caregiver dyads, cognitive reappraisal was positively associated with posttraumatic growth in themselves and each other, whereas both illness perception and expressive suppression were negatively associated with posttraumatic growth.ConclusionReducing negative illness perceptions and expressive suppression may promote posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Facilitating cognitive reappraisal may be useful in enhancing posttraumatic growth, which provides direction for future intervention research. Healthcare professionals should view lung cancer chemotherapy patients and their family caregivers as a whole and develop dyadic interventions.

Objectives: The main focus of previous research into coping with breast cancer, have been mostly with regards to the negative impacts such as emotional stress, anxiety, depression or cognitive dysfunction. However, patients also report positive changes that have come about as a result of their struggle with cancer. This is referred to as posttraumatic growth (PTG). The aim of this study was to assess the presence of PTG in breast cancer patients at two measurements and to explore the association between personality traits (resilience, optimism, self-efficacy) and positive emotions on PTG. Patients and Methods: The study group comprised of 80 women (with a mean age of 53.6 years, SD=10.2) recently diagnosed with stage I to III breast cancer. They completed self-report measures of PTG, resilience, optimism, self-efficacy and positive emotions up to three weeks after diagnose (t1) and then following by an update six months later (t2). Sociodemographic characteristics, emotional distress, anxiety and depression were also recorded. Results: Planned comparison: Breast cancer patients showed an increase of PTG from t1 to t2 (p=.00035). Resilience, optimism, self-efficacy and positive emotions did not change in the total sample from t1 to t2. Emotional distress, anxiety and depression have significantly declined from t1 to t2 (anxiety p=.015, depression p=.029, emotional distress p=.000065). Moreover, we found a significant positive correlation between positive emotions to PTG (r=-.386, p=.0004) and optimism to PTG (r=.334, p=.002) at t2, respectively. Depression t2 correlated negatively to PTG at t2 (r=-.264 p=.018). Explorative results: We also calculated the difference between PTG t2 and t1. We found 67.5% (n=54) of the patients with an increase of PTG and 32.5% (n=26) without or with negative change. In a subgroup analysis we noticed that patients without benefit of PTG showed a decline of resilience (p=.015), self-efficacy (p=.028) and positive emotions (p=.045) between t1 and t2. Furthermore, anxiety and depression did not improve from t1 to t2 in this group. Conclusions: Positive emotions and optimism represent indicators of PTG in breast cancer patients. A decline of anxiety and depression is associated with a higher rate of PTG. Psycho-oncological strategies related to these factors may support PTG in breast cancer patients. Future studies are needed to search for effective interventions to support patients in PTG. Citation Format: Berndt U, Gottschlik Y, Leplow B, Thomssen C. Factors that influence posttraumatic growth in patients with breast cancer: A longitudinal trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-19-03.

Background: Diagnosis of cancer is a traumatic experience. But cancer patients may have some positive experiences that are called post traumatic growth (PTG). The aim of this study was to determine the rate of post-traumatic growth in cancer patients and its relationship with social support and hope. Materials and Methods: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. Population included of 112 all adult patients with gastrointestinal cancer who referred to medical centers affiliated to Shiraz University of Medical Sciences. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed by SPSS software (version 23.0). P&lt;0.05 was considered statistically significant. Analytical data were analyzed using the Pearson correlation coefficient, sample t test, one-way analysis of variance independent and multiple regression analysis. In the case of non-normal distribution, the equivalent nonparametric analysis was used. Results: The mean score (SD (for PTG was 81.37)15.64(which is considered as high level. The mean score (SD) for hope, and SS was 195.20 (24.92), and 97.39 (11.37), respectively. A significant positive correlation was found between PTG and both hope (r=0.687, P˂0.05) and SS (r=0.636, P˂0.05). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P˂0.05). According to multiple regression analysis hope had a higher effect on PTG (ẞ=0.613) compared to SS (ẞ=0.192). Conclusion: The results showed a good level of PTG among the cancer patients. Regarding the association between PTG with the perceived SS and hope, health care providers can help their patient by hope instillation and providing social support.

The purpose of this study was to determine the effectiveness of a brief mindfulness based intervention to promote posttraumatic growth in cancer patients. The research design used was untreated control group design with pretest and posttest samples. Subjects in this study were 21 cancer patients that were divided into an experimental group (n = 10) and a control group (n = 11). Data were analyzed using Anova Mixed Design. The analysis showed significant changes of posttraumatic growth in the experimental group (MD=-14,400; p=0,000, p&lt;0,05) and in the control group changes of posttraumatic growth were not significant (MD=-0,273, p=0,914, p&gt;0,05). The results show that a brief mindfulness based intervention, which in this case is mindfulness training and yield significant results towards increased scores of posttraumatic growth in cancer patients. Hence, mindfulness based intervention can be used as one of psychotherapy to help individual psychologically growth.

Posttraumatic growth (PTG), defined as positive psychological changes following traumatic events, has been observed in some hematological cancer patients during their disease course. These changes, encompassing shifts in life perspective, interpersonal relationships, and self-perception, are critical for psychological recovery. However, the interplay of social support, coping strategies, anxiety, and depression in shaping PTG remains unclear. Therefore, the aim of this study was to explore these associations in hematological cancer patients using a hypothetical model. From August 2019 to May 2021, a cross-sectional survey was conducted with 474 hospitalized patients with hematological cancer at West China Hospital, Sichuan University, China (a tertiary hospital). The Social Support Rating Scale, Medical Coping Modes Questionnaire, Hospital Anxiety and Depression Scale, and Posttraumatic Growth Inventory were used for data collection. Correlation and regression analyses were performed using SPSS 26.0, a structural equation model was constructed using AMOS 24.0 software, and the confidence interval of the mediating effect was calculated using the bias-corrected bootstrap method. Social support was positively associated with PTG in hematological cancer patients (β = 0.564, P = 0.004). Avoidance (β = 0.199, P = 0.034) and acceptance-resignation (β = -0.315, P = 0.002) coping strategies mediated this association, with depression (β = -0.123, P = 0.009) further mediating the effects of coping strategies on PTG. These findings provide a basis for further research on PTG in cancer patients, particularly with respect to coping strategies in various dimensions. Enhancing social support and addressing maladaptive coping may promote PTG. Tailored interventions targeting depression management and culturally sensitive support systems are recommended to enhance PTG.

Objectives: Active and adaptive coping strategies have been identified as factors that can assist cancer patients in effectively managing and overcoming the crisis, leading to the potential for post-traumatic growth during the diagnosis and treatment stages. Psychological flexibility is another factor that can protect individuals and promote more adaptive reactions to traumatic situations. The study aims to examine the investigation of the mediation role of coping with stress in the relationship between psychological flexibility and posttraumatic growth in cancer patients. Methods: This study was conducted with 97 (63 women, 34 male) participants aged between 38 and 82 who are literate and diagnosed with breast cancer or gynecological cancers (endometrial, cervical, vulvar) undergoing radiotherapy planning at the Radiation Oncology Clinic of Zonguldak Bülent Ecevit University Hospital. Demographic Information Form, Psychological Flexibility Scale, Post-Traumatic Growth Inventory, and Coping Styles Scale were applied to the participants. The mediation effects were interpreted using bootstrap confidence intervals and VAF values. Results: This study showed that the active coping styles partially mediated the relationship between psychological flexibility and posttraumatic growth. Conclusion: In this regard, by organizing psychoeducational programs and interventions aimed at increasing psychological flexibility for individuals diagnosed with cancer or undergoing treatment, individuals can be enabled to cope with stress more actively, and thus post-traumatic growth can be achieved.

IntroductionThe 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.MethodsA 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.Results889 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]).DiscussionIn 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.