Abstract
Posttraumatic growth (PTG) refers to positive psychological changes resulting from individuals' inner struggles with traumatic events such as life-threatening illness. Although palliative care patients are confronted with their own mortality, little is known about their PTG experience. This study investigates whether PTG is an empirically relevant concept for palliative patients by assessing the prevalence and areas of growth, and examining associations with psychological distress and quality of life. Participants were recruited in Switzerland. Using validated questionnaires, we assessed PTG (Posttraumatic Growth Inventory, PTGI), psychological distress (Hospital Anxiety and Depression Scale), and quality of life (McGill-Quality of Life Questionnaire - Revised). We performed descriptive analyses, Spearman correlations, and linear regressions. Fifty-five patients completed the PTGI, 44% of whom experienced no/low growth, 47% moderate growth, and 9% high/very high growth. Participants experienced the greatest positive changes in terms of appreciating life and relating to others. We found significant negative bivariate correlations between PTG and psychological distress (r = -0.33) and between PTG and depression (r = -0.47). Linear regressions showed that PTG is associated with depression (β = -0.468; p = 0.000), but not with anxiety or quality of life (adjusted R2 = 0.219). Over half of our patients experienced moderate to very high growth, indicating that PTG is an empirically relevant psychological process in palliative care. PTG is associated with lower levels of depression, possibly as those experiencing growth are more able to process past traumas and build a more positive outlook on one's life and self. By contrast, the relative independence of anxiety and PTG points to the likely coexistence of positive and negative psychological responses to trauma. The lack of association between PTG and quality of life points to the uniqueness of the PTG concept in capturing how people access deeper meaning and greater appreciation of life along the path toward posttraumatic self-reconstruction.
Highlights
In the mid-1990s, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders introduced serious illness as a potential traumatic stressor
This study investigates whether Posttraumatic growth (PTG) is an empirically relevant concept for palliative care patients
We investigate associations between PTG and (i) psychological distress, exploring whether people faced with the heightened threat of advanced illness might experience co-occurring growth and distress; and (ii) quality of life, the most important outcome in palliative care, whose links with PTG in those with serious illness are still ill-understood
Summary
In the mid-1990s, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders introduced serious illness as a potential traumatic stressor. While illness-related traumas differ from those induced by natural or man-made disasters, insofar as they can be internal and repeated (multiple chronic stressors), empirical research suggests that individuals are likely to experience major psychological changes, whether negative or positive, in response to the trauma of illness (Sumalla et al, 2009; Swartzman et al, 2017). People with long-term illnesses are estimated to be two to three times more likely to experience psychological distress or mental health issues than the general population (Naylor et al, 2012). Recent studies suggest that one in two cancer patients experiences high levels of psychological distress, and that up to a third of cancer patients or survivors experience posttraumatic stress disorder (Abbey et al, 2015; Arnaboldi et al, 2017; Swartzman et al, 2017; Mehnert et al, 2018). Posttraumatic disorders affect between 9% and 27% of intensive care survivors (Jones et al, 2007; Battle et al, 2017; Hatch et al, 2018; Askari Hosseini et al, 2021), and up to 74% of people with HIV (Sherr et al, 2011)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
