Protocol for the psychotherapeutic group intervention for facilitating posttraumatic growth in nonmetastatic breast cancer patients

Relationship between sense of coherence and subjective well-being among family caregivers of breast cancer patients: a latent profile analysis

Objective

Sense of coherence (SOC) assists cancer-affected caregivers in overcoming challenges in the process of caregiving and may potentially influence an individual's subjective well-being (SWB). This study aimed to explore distinct SOC profiles among caregivers of breast cancer patients, identify the distribution differences of these profiles in sociodemographic and clinical characteristics, and explore their relationship with SWB.

Methods

A total of 360 patients with caregivers of breast cancer patients from one tertiary hospitals in Jiangsu completed the Sociodemographic and clinical characteristics, the Sense of Coherence Scale (SOC-13), and the General Subjective Well-Being Schedule (GWB). Mplus 8.3 for latent profile was performed to identify SOC classes. Multivariate logistic regression was used to analyze the impact of various factors on the different categories, and ANOVA was applied to compare the SWB among caregivers of different categories.

Results

Three latent profiles of SOC were identified: the "low sense of coherence-meaning group" (7.9%), the "moderate sense of coherence-manageability group" (37.3%), and the "high sense of coherence-optimism group" (54.7%). Age, residence, health status, financial pressure, caregiving duration, and breast cancer stage significantly influenced the distribution of SOC in caregivers of breast cancer patients. The SWB level differed significantly among these three categories.

Conclusion

This study identified three distinct classes of SOC among caregivers. It is recommended that health care providers screen caregivers with diverse profiles of SOC and pay more attention to young, rural, long-term caregiving duration, heavy economic burden, and caregivers in poor physical condition.

Group Intervention Program to Facilitate Post-Traumatic Growth and Reduce Stigma in HIV

Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main objective was to evaluate the effectiveness of an intervention in increasing PTG and decreasing stigma in HIV, as well as to explore relationships between the variables. Methods: Quasi-experimental design with a sample of 42 HIV-positive adults (M = 46.26, SD = 11.90). The experimental group (EG) was subjected to a 9-week group intervention. Instruments: CBI, PTGI-X, PSS-10, HIV stigma, emotional expression, HIV stress indicators, HIV literacy, and skills. Multiple linear regression analysis was performed to assess the relationship between the variables. Results: There was an increase in PTG and a significant decrease in stigma in all domains and subscales in the EG. Compared to the control group, stigma (t(42) = -3.040, p = 0.004) and negative self-image (W = -2.937, p = 0.003) were significant, showing the efficacy of the intervention. Discussion: The intervention demonstrated success in facilitating PTG, attesting that in order to increase PTG, personal strength, and spiritual change, it is necessary to reduce stigma and negative self-image. The research provides more information on group interventions for PTG in HIV, relationships between variables, and population-specific knowledge for professionals.

Associations of illness perception and social support with fear of progression in young and middle-aged adults with digestive system cancer: A cross-sectional study

PURPOSE

While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP.

METHODS

This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses.

RESULTS

The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients.

CONCLUSIONS

Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.

Trait rumination in post-stress growth among Chinese college students: the chain mediating effect of distress disclosure and perceived social support

Background

Rumination has emerged as a significant factor contributing to personal growth following periods of stress or trauma. The present study aimed to investigate the relationship between trait rumination and post-stress growth (PSG) within the context of Chinese college students who encounter mild stressors in their daily lives. Moreover, we aim to evaluate the potential mediating roles played by both distress disclosure and perceived social support in this dynamic relationship.

Method

All participants completed assessments using the Adolescent Self-Rating Life Events Checklist, Rumination Response Scale, Post-Stress Growth Inventory, Distress Disclosure Index, and Perceived Social Support Scale. Correlation and mediation analyses were conducted using SPSS PROCESS 4 MACRO.

Results

All students reported experiencing mild psychological impacts as a result of negative life events in the past year and displayed moderate levels of PSG. There was no significant correlation observed between the effects of negative life events and PSG. Significant negative correlations were found between trait rumination and distress disclosure, perceived social support, and PSG. Distress disclosure and perceived social support jointly operated as sequential mediators in the relationship between trait rumination and PSG among all the participants. Qualitative analyses revealed different correlation patterns of high- versus low-ruminator.

Conclusion

Trait rumination affects PSG both directly and indirectly, through its influence on distress disclosure and perceived social support. Our results emphasize the significance of actively participating in distress disclosure and nurturing a robust sense of social support to counteract the detrimental effects of rumination on post-stress growth among Chinese college students.

Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review

Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.

Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors

BACKGROUND

Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors.

AIMS

In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors.

METHOD

Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2.

RESULTS

The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model.

LIMITATIONS

Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.

The effectiveness of group problem-solving therapy on women's sexual function and satisfaction after mastectomy surgery

Background

Breast cancer is the second cause of death and the most common cancer in women worldwide, threatening different aspects of individual and mental health, quality of life, sexual function, and sexual satisfaction. This study aimed to determine the effectiveness of group counseling based on a problem-solving solution on women's sexual function and satisfaction after mastectomy surgery.

Methods

The present research was an open pilot study, with a pretest, a post-test, and a follow-up period. Of women referred to the Tehran Breast Cancer Institute, 32 were selected using convenience sampling. The group received eight 90-min sessions of problem-solving solution counseling. This approach is based on cognitive-behavioral therapy and can improve an individual's ability to cope with stressful life experiences. The data collection tool was FSFI and sexual satisfaction questionnaires, which were filled before the intervention (baseline), immediately after the intervention, and one month later (follow up). Data analysis was performed using SPSS 21 statistical software application at the certainty level of 95% (P < 0.05).

Results

The mean FSFI score increased from 18.37 ± 8.35 before the intervention to 20.88 ± 7.67 immediately after the intervention and 22.95 ± 5.79 one month later (P < 0.0001). Also, the mean sexual satisfaction score was 65.27 ± 5.98, 68.08 ± 5.61, and 70.46 ± 5.35 before the intervention, immediately after the intervention, and one month later, respectively (P < 0.05). The results also showed that although the two components of sexual function and satisfaction were statistically significant after sexual counseling, this improvement was not clinically progressive. The mean sexual function and satisfaction score was still low after sexual counseling.

Conclusions

It was observed that sexual function and satisfaction were improving among the patients after the intervention. Thus, sexual health counseling sessions are recommended for breast cancer patients.

The mediating and moderating roles of resilience in the relationship between anxiety, depression, and post-traumatic growth among breast cancer patients based on structural equation modeling: An observational study

This study aimed to analyze the moderation and moderation effects of resilience on the anxiety, depression impact on post-traumatic growth (PTG) among breast cancer patients undergoing chemotherapy based on structural equation modeling, and confirmed whether resilience was a mediating and regulating variable between anxiety, depression, and post-traumatic growth. In addition, whether anxiety and depression have different effects on PTG under different levels of psychological resilience.This cross-sectional study was conducted from November 2017 to January 2019, with subjects of 260 breast cancer patients undergoing chemotherapy in the department of breast and general surgery of a tertiary general hospital in Shanxi Province of China.Data were collected according to the General Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and the posttraumatic growth inventory. Estimated values of model path coefficients and significance test were performed to confirm the mediation effect. Hierarchical regression and simple slope test were used to analyze the regulation effect.Resilience showed significant correlations with anxiety, depression and PTG (all P < .01). Estimated values of model path coefficients and significance test results indicated that the mediating role of resilience was remarkable and it could regulate anxiety, depression, and PTG.The anxiety, depression and resilience affected their PTG of breast cancer patients during chemotherapy, suggesting the need to establish a cooperative mechanism based on the concept of multidisciplinary collaboration. Professional psychological intervention should be used to reduce anxiety and depression and to explore the potential of resilience to promote their PTG.

The Effect of Cognitive-Emotional Intervention on Growth and Posttraumatic Stress in Mothers of Children With Cancer: A Randomized Clinical Trial

BACKGROUND

To diminish the negative impact and improve the positive outcomes on the parents of children with cancer, it is crucial to attend to their problems. This is especially significant in the case of mothers as the main caregivers. The present study aimed at evaluating the efficiency of cognitive-emotional intervention on growth and posttraumatic stress in mothers of children with cancer hospitalized in the chemotherapy ward.

PROCEDURE

This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of a hospital located in southeastern Iran in 2018. The eligible mothers were chosen and randomly assigned to intervention and control groups. Mothers in the intervention group as a whole received 5 sessions of cognitive-emotional intervention. The sessions were held twice a week, each lasting 60 to 90 minutes. Sixteen weeks after the intervention, posttest data were collected through the Posttraumatic Stress Disorder Checklist and Posttraumatic Growth Inventory. The data were then analyzed using SPSS 21 utilizing statistical tests including independent and paired t tests, χ, and covariance analysis.

RESULTS

The results show that the mean value of posttraumatic stress in mothers of children with cancer after cognitive-emotional training in the intervention group (25.92±5.29) was significantly lower than that in the control group (44.94±11.92; P=0.0001). Moreover, in the posttest, the mean value of posttraumatic growth in the intervention group (92.06±5.50) was significantly more than that in the control group (62.98±15.08; P=0.0001).

CONCLUSIONS

Alleviating posttraumatic stress, the cognitive-emotional intervention proposed in this research had a significant and positive impact on posttraumatic growth in mothers of children diagnosed with cancer. Therefore, implementing this intervention in the chemotherapy department and throughout the course of the children's treatment is highly recommended for their caregivers, especially mothers of children diagnosed with cancer.

A Longitudinal Investigation of Posttraumatic Growth and Quality of Life in Liver Transplant Recipients

Background:

What does it mean to adjust to a liver transplant? Quality of life research has offered an impairment model, defining adjustment as the absence of diagnosed psychological disorder or of limitations in physical functioning. Recently emerging research on posttraumatic growth testifies the prevalence of positive life changes following the life-threatening illnesses. The present study aimed to verify the presence of the posttraumatic growth process in liver transplant patients and its relationship with traditional quality of life.

Methods:

The research was a longitudinally descriptive study. A sample of 233 liver transplant patients were assessed with the Posttraumatic Growth Inventory and the Functional Assessment of Chronic Illness Therapy General.

Results:

Over 50% of patients showed moderate-high levels in all dimensions of the Posttraumatic Growth Inventory. Further posttraumatic growth is correlated with the functional and social dimensions of quality of life construct and not with physical and emotional functioning.

Conclusion:

These results confirmed that posttraumatic growth is related to a different definition of well-being than the one traditionally used in the assessment of quality of life. Adjustment to liver transplant is a complex and systemic process, which requires a multidisciplinary approach to be able to support and encourages adaptation through all the needed functional elements. An interesting perspective is offered by the narrative medicine approach, that highlighted the importance to pay specific attention to the words and expression used by patients related to changes in life and not only to traditional words reporting physical status.

The Effect of Cognitive-Emotional Training on Post-traumatic Growth in Women with Breast Cancer in Middle East

Overcoming distresses and negative consequences of serious crises such as cancers can lead to perception of positive changes in the patients. It is necessary to design and test the psychological interventions that can improve post-traumatic growth. The objective of this study was to determine the effect of cognitive-emotional training on post-traumatic growth in women with breast cancer referred to the department of chemotherapy. This is a quasi-experimental study and it was performed on 85 patients with breast cancer who referred to an educational hospital in southeastern of Iran in 2017. The eligible patients were selected through convenience method sampling among the patients and they randomly allocated into intervention and control groups. The intervention group received five sessions of emotional-cognitive training in two sessions per week. Each session lasted 60-90 min. The posttest data were collected by post-traumatic growth inventory (PTGI) 20 weeks after the end of the last intervention session. Collected data were analyzed by SPSS software version 21.00 using independent t test, paired t test, and Chi-square tests for demographic analysis. The results indicated that there is no significant difference in both groups in terms of individual variables such as age, marriage, duration of disease, and degree progression of cancer. Although the mean of PTG scores in posttest and the mean of variations in the PTG scores in the intervention group were 77.48 ± 11.18 and 25.81 ± 12.24, respectively, and it was significantly higher than the control group, 53.95 ± 14.86 and 7.69 ± 9, respectively (mean scores of PTG: p < .0001; mean changes of PTG: p < .001). According to the results of this study, cognitive-behavioral intervention had a positive and significant effect on post-traumatic growth in women with breast cancer. If intervention is found to be effective, cognitive and emotional strategies of such interventions could be integrated into daily clinical practice as a way to promote PTG in women who are being treated for breast cancer.

Eye Movement Desensitization and Reprocessing to Facilitate Posttraumatic Growth: A Prospective Clinical Pilot Study on Ferry Disaster Survivors

Objective

The purpose of this study was to investigate the therapeutic effects of eye movement desensitization and reprocessing (EMDR) on post-traumatic growth (PTG).

Methods

This study was conducted using a sample of ten survivors of a large-scale maritime disaster that occurred in the Yellow Sea, South Korea, in April 2014. A total of eight EMDR sessions were administered by a psychiatrist at two-week intervals over a period of five months, starting two or three months after the accident. Post-Traumatic Growth Inventory (PTGI), Stress-Related Growth Scale (SRGS), Clinician-Administered PTSD Scale (CAPS), and Connor-Davidson Resilience Scale (CD-RISC) were measured before treatment, after sessions 4 and 8, and at three months after treatment completion.

Results

After three months from treatment completion, significant increases were observed in PTG (PTGI: Z(8)=−2.380, p=0.017; SRGS: Z(8)=−2.380, p=0.017) and resilience (CD-RISC: Z(8)=−2.386, p=0.017). A decrease in post-traumatic stress disorder (PTSD) level was also significant (CAPS: Z(8)=−2.176, p=0.030). The reduction of CAPS scores was correlated with increases of PTGI (rho=0.78, p=0.023) and SRGS (rho=0.79, p=0.020) scores. The changes in CAPS, PTGI, and SRGS scores between time point of end 8-session and three months follow-up was not significant (all p>0.05). Subjects with higher pre-treatment CD-RISC scores showed more significant improvements in PTGI (rho=0.88, p=0.004) and SRGS (rho=0.83, p=0.010) scores after treatment than did those with lower pre-treatment CD-RISC scores.

Conclusion

EMDR therapy using standard protocol for trauma processing helped facilitating PTG in disaster survivors. To generalize these findings, further controlled studies comparing with other treatment modalities for PTSD are needed.

Web-based remote psychological intervention improves cancer treatment

Web-based-remote (WBR) intervention is a new approach that incorporates smart control technology and modern medicine to monitor patient compliance. It is based on computer control and communication technology. This study is to explore the benefits of WBR psychological intervention for cancer treatment. 128 patients diagnosed with cancer by Pathology Department of our hospital between 1 February 2013 and 1 August 2013 were included. Patients were randomly assigned to intervention and control group (n = 64). The Questionnaire-Core 30 (QLQ-C30) was used for the survey. Intervention group received WBR psychological intervention in addition to regular clinical follow-up care. Control group only received regular clinical follow-up care. The QLQ-C30 score was significantly better in the intervention group than the control group when the intervention and control groups were followed for three months. In conclusion, WBR psychological intervention substantially improves the quality of life in patients during cancer treatment.