Positive consequences of head and neck cancer: key correlates of finding benefit

Cognitive behavioral stress management affects different dimensions of benefit finding in breast cancer survivors: a multilevel mediation model

Objective. This study aimed to confirm the multidimensionality of benefit finding (BF), or silver linings within the cancer experience, assess the effects of Cognitive Behavioral Stress Management (CBSM) on those dimensions, and test the mediating role of perceived stress management skills targeted by CBSM.Methods. This secondary analysis used data from 240 women with stage 0-III breast cancer who completed measures of BF (Benefit Finding Scale) and perceived stress management skills (PSMS) at baseline, 6-months, and 12-months post-randomization into CBSM or a psycho-education condition. We tested a six-factor BF model using Confirmatory Factor Analysis and assessed CBSM-related changes in BF and PSMS using Hierarchical Linear Models. We included significantly affected BF dimensions in mediation models.Results. A six-factor model of BF had good fit [χ2(212) = 391.5, p < .001; CFI = 0.94; RMSEA = 0.06; SRMR = 0.04]. CBSM positively affected changes in personal growth (β = 0.06, p = .01), social relations (β = 0.05, p = .05), and worldview (β = 0.05, p = .02) BF. Perceived relaxation skill increases significantly mediated changes in personal growth (β = 0.03, p = .04) and social relations (β = 0.03, p = .04).Conclusion. Some aspects of perceived stress management skills appear to account for specific BF dimensions and should be considered in future efforts to develop interventions to modulate BF.

Factors associated with benefit finding and mental health of patients with cancer: a systematic review

PURPOSE

This systematic review was performed to identify the association between benefit finding (BF) and anxiety, depression, and distress, as well as to find factors related to BF in adult cancer patients.

METHODS

Five English databases and four Chinese databases were searched to identify eligible articles about BF in adult cancer patients from inception to 4 July 2021. Literature screening, data extraction, and quality assessment were carried out by two reviewers independently according to the inclusion and exclusion criteria. Qualitative synthesis was used to summarize the results.

RESULTS

Twenty-one studies involving 9601 cancer patients were included in this study. Qualitative analysis showed that BF was negatively related to anxiety, depression, and distress. Factors associated with BF included sociodemographic factors, disease-related factors, and psychological and environmental factors.

CONCLUSIONS

Healthcare providers should pay attention to the summarized factors of BF and construct intervention programs based on the controllable factors to improve BF in adult cancer patients, thus promoting the recovery of patients.

Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time?

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.

Benefit finding in long-term prostate cancer survivors

Purpose

Benefit finding (BF) represents possible positive changes that people may experience after cancer diagnosis and treatment and has proven to be valuable to the psychological outcome. Knowledge of such beneficial consequences of prostate cancer (PCa) is limited in long-term survivors (> 5 years). Thus, the present study investigated the occurrence of benefit finding (BF) and its determinants in a large sample of (very-) long-term PCa survivors.

Methods

BF was assessed in 4252 PCa survivors from the German database “Familial Prostate Cancer” using the German version of the Benefit Finding Scale (BFS). Associations between BF and sociodemographic, clinical, and psychosocial (e.g., depressive and anxiety symptoms and perceived severity of the disease experience) variables were analyzed using hierarchical multiple linear regression analysis.

Results

Mean age at survey was 77.4 years (SD = 6.2) after a mean follow-up of 14.8 years (SD = 3.8). Mean BFS score was 3.14 (SD = 1.0); the prevalence of moderate-to-high BF (score ≥ 3) was 59.7%. Younger age at diagnosis, lower educational level, and higher perceived severity of the disease experience were predictive of BF. Objective disease severity or family history of PCa was not uniquely associated with BF.

Conclusions

BF occurs in older, (very-) long-term PCa survivors. Our findings suggest that the self-asserted severity of the disease experience in a patient’s biography is linked to BF in the survivorship course above all tangible sociodemographic and clinical factors.

Implications for cancer survivors

PCa survivors may express BF regardless of clinical disease severity. Treating urologists should consider inquiring BF to enrich a patient’s cancer narrative.

Are Posttraumatic Stress Symptoms and Avoidant Coping Inhibitory Factors? The Association Between Posttraumatic Growth and Quality of Life Among Low-Grade Gliomas Patients in China

Background: Diagnosing with low-grade gliomas (LGGs) can be a very shocking and stressful experience, a traumatic event potentially leading to the development of posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Understanding how patients cognitively and behaviorally response to their diagnosing is also important to postoperative treatment. Thus, the current study explored the association between PTG and quality of life (QoL) of Chinese patients with LGGs. The moderation effects of coping strategies and PTSS on the relationship between PTG and QoL have been examined as well. Methods: Posttraumatic stress symptoms, Posttraumatic growth, coping strategies, and QoL were measured by using self-report surveys. Three hundred and thirty patients completed surveys approximately 1 month after surgery. We used three multiple regression models and added interaction terms in these models to test the moderation effects of PTSS and coping strategies on the relationship between PTG and QoL. Results: The results of hierarchical multiple regression suggested that PTG significantly predicted QoL, both PTSS and coping strategies moderated the association between PTG and QoL. Specifically, the association between PTG and QoL for patients who have non-significant PTSS is stronger than those who have significant PTSS. Furthermore, as the score of Avoidant Coping increases, the association between PTG and QoL becomes weaker. Conclusion: Posttraumatic growth may help to improve the QoL of LGGs patients, but PTSS and Avoidant Coping impeded the positive effect of PTG on QoL.

Benefit finding in renal transplantation and its association with psychological and clinical correlates: A prospective study

Objectives

The identification of positive psychological changes, including benefit finding (BF), in chronic illness has gained substantial interest. However, less is known about BF in the context of a positive medical intervention. End‐stage renal disease (ESRD) can be regarded as a burdensome condition, but transplantation is expected to restore physical and psychological functioning to a large extent after a period of illness. The aim of this study was to examine (1) changes in BF from pre‐ to 12 months post‐transplantation, (2) the concurrent association of disease‐related characteristics and optimism to BF, and (3) the potential causal relations between BF and distress.

Methods

In this longitudinal study, 319 patients completed questionnaires before, 3 months, 6 months, and/or 12 months post‐transplantation. Multilevel models were used for the analyses. Measures included the Illness Cognitions Questionnaire to measure BF, the Life Orientation Test to measure optimism, and the General Health Questionnaire to measure distress.

Results

Benefit finding increased from pre‐ to post‐transplantation. Fewer symptoms and comorbidities, and more optimism, were related to more BF over all time‐points. The direction of the relation between BF and distress changed over time. Before transplantation, distress predicted an increase in BF, whereas post‐transplantation, distress predicted a decrease in BF. The causal relation between BF and distress post‐transplantation appeared to be reciprocal.

Conclusions

A positive medical intervention such as renal transplantation might facilitate the development of BF. This study indicates the need for longitudinal research on the relation between BF and psychological health in the face of positive events.

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.

Psychological variables associated with quality of life following primary treatment for head and neck cancer: a systematic review of the literature from 2004 to 2015

OBJECTIVE

There has been a recent proliferation of research on quality of life (QoL) in head and neck cancer (HNC). The objective of this review was to systematically examine the evidence on psychological factors associated with QoL outcomes for HNC survivors in the post-treatment period published during 2004-2015.

METHODS

Five databases were searched for studies investigating psychological factors associated with QoL in HNC survivors. Empirical studies published between January 2004 and June 2015 were included if they measured QoL as an outcome following treatment using a reliable and valid measure, examined its association with at least one psychological factor and included at least 50 HNC survivors.

RESULTS

Twenty-four publications describing 19 studies (9 cross-sectional, 10 prospective) involving 2,263 HNC survivors were included. There was considerable heterogeneity in study design and diversity in measurement and analysis. Distress-related variables (depression, anxiety, distress) were most frequently investigated, and mostly reported negative associations with QoL outcomes. Associations were also observed between other psychological factors (e.g., coping, neuroticism and fear of recurrence) and QoL.

CONCLUSIONS

Several psychological factors predict QoL among HNC survivors who have completed treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL following treatment. Longitudinal and population-based studies incorporating more systematic and standardised measurement approaches are needed to better understand relationships between psychological factors and QoL and to inform the development of intervention and supportive care strategies.Copyright © 2016 John Wiley & Sons, Ltd.

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.

Living an everyday life with head and neck cancer 2-2.5 years post-diagnosis - A qualitative prospective study of 56 patients

RATIONALE

There are many studies available describing how patients are affected by head and neck cancer (HNC) and its treatment. Usually these studies are quantitative and focus on assessing patients' quality of life or distress post-treatment. These studies are important, but they are of limited value if we are interested in understanding more about HNC in an everyday life context.

OBJECTIVE

The purpose was to determine how life was lived and valued during and after treatment for HNC and to detect different transitions in returning to everyday life.

METHODS

During 2009-2012, 56 patients with HNC were consecutively included, and interviewed at 6, 12, and 24 months post-treatment about how they lived their lives. All patients received primary treatment at a tertiary referral university hospital in Sweden.

RESULTS

Four different trajectories and transitions emerged. The first group (n = 15) evaluated their illness experience as a past parenthesis in their life suggesting that they had psychologically left the illness behind. In the second group (n = 9), the impact of the disease seemed to be diluted by other strains in their life, and although these patients to some extent were still hampered by side effects, they regarded them as 'no big deal'. The cancer really made a difference in the third group (n = 12) in both positive and negative ways and seemed to reflect a balance between such effects. In the fourth group (n = 20), the physical and/or psychological problems predominated and the patients' lives had changed for the worse.

CONCLUSION

The narratives showed that being afflicted by HNC has different impacts depending on how the patients live their lives - it is a matter of individual transition in an everyday life context. This idiosyncrasy challenges the meaningfulness of screening efforts to identify vulnerable groups for psychosocial intervention.

Observations of benefit finding in head and neck cancer patients

The management of head and neck cancer (HNC) can lead to potentially severe physical, functional and psychological disturbances. As a result, many HNC patients develop symptoms of depression following diagnosis and treatment. Finding benefit in a disease and its treatment can reduce the symptoms of depression and enhance quality of life (QOL). 92 patients from the Head and Neck Cancer Clinic at Auckland Hospital completed measures of unmet needs and quality of life at diagnosis, and completed measures of benefit finding, coping, fear of recurrence and depression 12-18 months later. Patients reported at least moderate benefit finding in the majority of areas. More benefit finding was predicted by the presence of more advanced disease, Maori/Pacific Island ethnicity, lower baseline QOL, and the use of active coping strategies. These findings support the view that screening for QOL at diagnosis and facilitating the development of coping skills may lead to improved benefit finding and psychological adjustment in people with head and neck cancer. Identification of the factors that facilitate benefit finding may assist management of patients after treatment for HNC.

Observations of benefit finding in head and neck cancer patients

The management of head and neck cancer (HNC) can lead to potentially severe physical, functional and psychological disturbances. As a result, many HNC patients develop symptoms of depression following diagnosis and treatment. Finding benefit in a disease and its treatment can reduce the symptoms of depression and enhance quality of life (QOL). 92 patients from the Head and Neck Cancer Clinic at Auckland Hospital completed measures of unmet needs and quality of life at diagnosis, and completed measures of benefit finding, coping, fear of recurrence and depression 12-18 months later. Patients reported at least moderate benefit finding in the majority of areas. More benefit finding was predicted by the presence of more advanced disease, Maori/Pacific Island ethnicity, lower baseline QOL, and the use of active coping strategies. These findings support the view that screening for QOL at diagnosis and facilitating the development of coping skills may lead to improved benefit finding and psychological adjustment in people with head and neck cancer. Identification of the factors that facilitate benefit finding may assist management of patients after treatment for HNC.

Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis

OBJECTIVE

The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations.

METHOD

A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG.

RESULTS

Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = -0.33), and physical quality of life (r = -0.44). PTG was associated with age (r = -0.08), gender (r = -0.15), distress (r = -0.16), depression (r = -0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13).

CONCLUSIONS

Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG.

Social support mediates the association between benefit finding and quality of life in caregivers

The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life.

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

Background. The impact of head and neck cancer (HNC) in long-term survivors differs widely among individuals, and a significant number of them suffer from the negative effects of disease, whereas others report significant positive effect. This systematic review investigated the evidence the implications of treatment for HNC and subsequent development of Benefit Finding (BF) or Posttraumatic Growth (PTG). Purpose. To understand how differing medical, psychological and social characteristics of HNC may lead to BF/PTG and subsequently inform post-treatment interventions to encourage positive outcomes. Method. In February 2012, five databases including Pubmed, and Psych Info, were searched, for peer-reviewed English-language publications. Search strings included key words pertaining to HNC, BF, and PTG. One thousand three hundred and sixty three publications were identified, reviewed, and reduced following Cochrane guidelines and inclusion/exclusion criteria specified by a group of maxillofacial consultants and psychologists. Publications were then quality assessed using the CASP Cohort Critical Appraisal tool. Findings. Five manuscripts met the search and selection criteria, and were sourced for review. All studies were identified as being level IIb evidence which is a medium level of quality. The majority of studies investigated benefit finding (80%) and were split between recruiting participant via cancer clinics and postal survey. They focused on the medical, psychological and social characteristics of the patient following completion of treatment for HNC. Conclusion. Demographic factors across the papers showed similar patterns of relationships across BF and PTG; that higher education/qualification and cohabitation/marriage are associated with increased BF/PTG. Similarly, overlap with disease characteristics and psychosocial factors where hope and optimism were both positively correlated with increased reported BF/PTG.

Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine

Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately 650,000 new cases are diagnosed, making HNC the 6th most common type of cancer in the world. Despite this, however, HNC remains understudied in behavioral medicine. In this article, the authors review available evidence regarding several important psychosocial and behavioral factors associated with HNC diagnosis, treatment, and recovery, as well as various psychosocial interventions conducted in this patient population, before concluding with opportunities for behavioral medicine research and practice.

A prospective study of posttraumatic growth as assessed by self-report and family caregiver in the context of advanced cancer

OBJECTIVE

The study of posttraumatic growth (PTG) has burgeoned over the last decade, particularly in the area of oncology. The aims of the study were to: (1) describe PTG in patients with hepatobiliary carcinoma, (2) examine agreement between the patient and caregiver measures of patient PTG, and (3) test the associations between PTG and other psychological factors and clinically relevant outcomes.

METHODS

Two hundred and two patients with hepatobiliary carcinoma completed a battery of standardized questionnaires that measured PTG, depressive symptoms, optimism, expressed emotion, and quality of life (QOL). A subsample of family caregivers also completed ratings of patient PTG, using the Posttraumatic Growth Inventory (PTGI), as well as their own PTG.

RESULTS

No significant increase in the patients' PTG was observed between diagnosis and 6-month follow-up with the exception of the Relating to Others subscale of the PTGI. PTG was not found to be associated with QOL or depressive symptoms. At diagnosis, the agreement between the patients' PTG and family caregivers' rating of patient PTG was found to be high (ICC=0.34-0.74, p=0.001-0.05). PTG was found to be significantly associated with optimism (r=0.20 p=0.02-0.05) and traumatic life events reported in the past 3 years, including recent losses (F(1, 52)=6.0, p=0.02) and severe physical injury (F(1, 52)=5.5, p=0.02). Caregivers reported PTG as a result of their loved one's diagnosis of cancer.

CONCLUSION

Preliminary results suggest that PTG is relatively stable over the first 6 months after diagnosis and changes as a result of a diagnosis of cancer were reported, and possibly observed, by others. Family caregivers also experience PTG as a result of their loved one's diagnosis of advanced cancer.

Coping processes relevant to posttraumatic growth: an evidence-based review

OBJECTIVE

This study aims to perform an evidence-based review on the quantitative data regarding coping processes related to posttraumatic growth in the field of oncology to facilitate understanding of posttraumatic growth in oral cavity cancer (OCC) patients.

MATERIAL AND METHODS

Pubmed, Medline, and PsycINFO were used for the search and the reference list checked for each selected article. Full articles meeting the inclusion criteria were retrieved. Only English articles were included.

RESULTS

The initial search yielded 934 publications; 64 "potentially relevant papers" and 21 "effective" papers formed the basis of this review. Personality traits and social support lead to development of positive coping methods in cancer patients. Overriding influences are benefit finding and meaning making. Specific coping processes were identified to be significantly associated with posttraumatic growth in patients suffering from different cancers and a need for additional prospective research regarding specific processes and outcomes among oral cavity cancer patients. A proposed theoretical model based on the evidence of management of other cancer research fields is suggested for patients with OCC.

CONCLUSION

An evidence-based review of coping strategies related to posttraumatic growth was performed which identified key coping strategies and factors that enhance coping processes. A conceptual model of coping strategies to enhance posttraumatic growth in OCC patients based on the scientific evidence attained is suggested to provide a more holistic approach to OCC management.

Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: a meta-analysis

There is increasing research on posttraumatic growth after life-threatening illnesses such as cancer and HIV/AIDS, although it is unclear whether growth confers any psychological or physical benefits in such samples. Consequently, this meta-analysis explored the relationship between posttraumatic growth and psychological and physical wellbeing in adults diagnosed with cancer or HIV/AIDS and examined potential moderators of these relationships. Analysis of 38 studies (N = 7927) of posttraumatic growth after cancer or HIV/AIDS revealed that growth was related to increased positive mental health, reduced negative mental health and better subjective physical health. Moderators of these relationships included time since the event, age, ethnicity, and type of negative mental health outcome. It is hoped that this synthesis will encourage further examination of the potentially complex relationship between posttraumatic growth and adjustment in individuals living with life-threatening medical conditions.

Posttraumatic growth among cancer patients in India

Cancer patients sometimes report positive life changes in addition to more harrowing ones. Theoretically, several cognitive processes are thought to contribute to posttraumatic growth, but few studies have examined these relationships empirically among cancer patients. Moreover, most research has been conducted in western developed countries. This preliminary study offered a novel examination of posttraumatic growth and its cognitive correlates among cancer patients in western India. As hypothesized, in bivariate analyses perceived growth was significantly associated with greater meaning-focused coping (sense-making, benefit-finding), and with reappraisal of worldviews. Growth was not related to subjective appraisals regarding illness threat or stressfulness. In multivariate analyses, reappraisal of worldviews was the strongest concurrent predictor of posttraumatic growth. Results suggest that deliberative cognitive processes merit further study.