Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory

Young-Mi Jung; Jin-Hee Park

doi:10.4040/jkan.2017.47.3.319

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Jung and Park: Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory

Original Article

J Korean Acad Nurs 2017;47(3):319-331.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.3.319

Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory

Young-Mi Jung¹, Jin-Hee Park^2,

¹Department of Nursing, College of Health Science, Cheongju University, Cheongju

²College of Nursing · Institute of Nursing Science, Ajou University, Suwon, Korea

Address reprint requests to : Park, Jin-Hee College of Nursing · Institute of Nursing Science, Ajou University, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-7019 Fax: +82-31-219-7020 E-mail: jhee@ajou.ac.kr

Received 17 September 2016 Revised 15 March 2017 Accepted 15 March 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to develop a scale to evaluate posttraumatic growth in patients with cancer and to examine the validity and reliability of the scale.

Methods

A literature review, semi-structured patient interviews and an expert panel consultation produced a 27 preliminary item questionnaire. Participants were 150 cancer patients recruited to test the reliability and validity of the preliminary scale. Data were analyzed using item analysis, exploratory factor analysis, convergent validity and internal consistency.

Results

Item reduction and exploratory factor analysis led to 23 items, grouped into five subscales which were labelled new possibilities (6 items), coping skills (5 items), preciousness of life (5 items), relating to others (4 items), and personal strength (3 items). Convergent validity was evaluated by total correlation with the Functional Assessment of Cancer Therapy-General (r=.45, p<.001). The final scale demonstrated satisfactory internal consistency (Cronbach's a =.94).

Conclusion

Findings from this study indicate that the Cancer-Specific Posttraumatic Growth Inventory has validity and reliability and is considered to be appropriate for assessing posttraumatic growth in patients with cancer.

Keywords: Neoplasm, Post-traumatic stress disorders, Psychological adaptation, Reproducibility of results

References

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Table 1.

Demographic and Clinical Characteristics of Participants (N=150)

Characteristics	Categories	n (%)	M±SD
Age(yr)	20~39	21 (14.0)	48.87±8.46
	40~49	61 (40.7)
	50~59	53 (35.3)
	≥60	15 (10.0)
Gender	Male	36 (24.0)
	Female	114 (76.0)
Educational level	≤Middle school	20 (13.3)
	High school	65 (43.3)
	≥University	65 (43.3)
Current spouse	No	25 (16.7)
	Yes	125 (83.3)
Religion	No	71 (47.3)
	Yes	79 (52.7)
Occupation	No	80 (53.4)
	Yes	70 (46.6)
Diagnosis	Breast cancer	82 (54.6)
	Stomach cancer	41 (27.3)
	Cervical/Ovarian cancer	17 (11.4)
	Colon/Rectal cancer	10 (6.7)
Cancer Stage	I	70 (46.6)
	II	53 (35.4)
	III	27 (18.0)
Treatment	Chemotherapy only	43 (28.6)
	Radiation therapy only	41 (27.4)
	Both chemotherapy	66 (44.0)
	and radiation therapy

Table 2.

Factor Analysis of the Cancer-Specific Posttraumatic Growth Inventory (N=150)

Factor	No.	Item	M±SD	Factor loading
				F1	F2	F3	F4	F5
New possibility	1	I am more likely to try to change things which need changing.	2.23±1.08	.81	.14	.14	.16	.04
	2	I developed new interests.	2.35±1.14	.74	.15	.15	.20	.12
	3	New opportunities are available which wouldn't have been	1.87±1.13	.73	.24	.09	.07	.34
		otherwise.
	4	I established a new path for my life.	2.37±1.14	.69	.06	.31	.18	.12
	5	I am able to do better things with my life.	2.31±1.21	.62	.27	.09	.34	.13
		(learning, family tour, volunteer work etc.)
	6	I have a greater feeling of self reliance.	2.32±1.06	.59	.49	.24	.05	.29
Coping skill	7	I am able to keep myself healthy and be more responsible for	2.74±0.94	.36	.74	.30	.10	.04
		my health.
	8	I am able to think positively in everything.	2.81±0.97	.22	.70	.06	.04	.38
	9	I am able to manage healthcare more actively.	2.93±0.95	.24	.65	.19	.30	-.14
		(change of lifestyle, diet therapy, exercise etc.)
	10	I am able to accept the changing environment due to cancer	2.78±0.91	-.03	.58	.15	.32	.42
		diagnosis and treatment.
	11	I am able to better understand others.	2.82±0.85	.21	.52	.40	.32	.18
Preciousness of	12	I am able to think that I am a precious and valuable person.	2.32±1.06	.23	.30	.73	-.03	.29
life	13	I felt how important my family is.	3.39±0.73	.16	.00	.72	.44	-.05
	14	I have clearly found out what true happiness is.	3.06±0.87	.23	.19	.68	.00	.29
	15	I can better appreciate each day.	3.11±0.84	.14	.25	.61	.18	.39
	16	I changed my priorities about what is important in life.	2.93±0.96	.38	.40	.51	.18	-.17
Relating to	17	I clearly see that I can count on people in times of trouble.	2.03±1.11	.19	.17	.13	.84	.07
others	18	I have a greater sense of closeness with other.	2.17±1.12	.16	.02	.01	.76	.34
	19	I can actively expressed my feelings to the around people.	2.18±1.13	.28	.30	.16	.65	.08
		(language, action, letter etc.)
	20	I have a deep and sincere relationship with friends or	2.48±1.20	.17	.37	.24	.58	.23
		significant others.
Personal	21	I am better able to accept the way things work out.	2.58±1.11	.22	.19	.20	.20	.72
strength	22	I discovered that I'm stronger than I thought I was.	2.88±0.89	.34	.03	.21	.29	.65
	23	I know better that I can handle difficulties.	2.54±1.17	.57	.19	.29	.14	.48
Eigen value				4.18	3.16	2.94	2.92	2.32
Explained variance (%)				18.2	13.7	12.8	12.7	10.1
Cummulative variance (%)				18.2	31.9	44.7	57.4	67.5
			KMO (Kaiser-Meyer-Olkin)= .87, c²=2357.50 (p<.001)
Total Cronbach’s a= .94				.88	.83	.82	.81	.80

Table 3.

Finding of Multi-trait/Multi-item Matrix Analysis (N=150)

Factor (n)	No.	Item	F1	F2	F3	F4	F5	2 Standard Error
New possibility	1	I am more likely to try to change things which need changing	.74	.42	.48	.41	.46	0.09
	2	I developed new interests.	.72	.47	.46	.44	.47	0.09
	3	New opportunities are available which wouldn't have been	.75	.51	.46	.42	.58	0.10
		otherwise.
	4	I established a new path for my life.	.79	.42	.51	.42	.52	0.07
	5	I am able to do better things with my life.	.63	.52	.44	.51	.51	0.10
		(learning, family tour, volunteer work etc.)
	6*	I have a greater feeling of self reliance.	.69	.65	.60	.46	.64	0.12
Coping skill	7	I am able to keep myself healthy and be more responsible for	.60	.74	.60	.42	.47	0.08
		my health.
	8	I am able to think positively in everything.	.49	.62	.43	.41	.44	0.11
	9	I am able to manage healthcare more actively.	.46	.60	.47	.47	.36	0.11
		(change of lifestyle, diet therapy, exercise etc.)
	10*	I am able to accept the changing environment due to cancer	.36	.58	.45	.50	.47	0.14
		diagnosis and treatment.
	11*	I am able to better understand others.	.53	.64	.60	.55	.44	0.11
Preciousness of	12	I am able to think that I am a precious and valuable person.	.50	.54	.71	.35	.54	0.08
life	13	I felt how important my family is.	.39	.39	.60	.47	.36	0.12
	14	I have clearly found out what true happiness is.	.46	.48	.64	.32	.48	0.12
	15	I can better appreciate each day.	.45	.51	.64	.44	.52	0.10
	16*	I changed my priorities about what is important in life.	.52	.55	.55	.38	.37	0.11
Relating to others	17	I clearly see that I can count on people in times of trouble.	.43	.47	.39	.76	.38	0.08
	18	I have a greater sense of closeness with other.	.36	.38	.31	.61	.45	0.15
	19	I can actively expressed my feelings to the around people.	.50	.53	.44	.65	.45	0.10
		(language, action, letter etc.)
	20*	I have a deep and sincere relationship with friends or	.48	.54	.47	.54	.40	0.12
		significant others.
Personal strength	21	I am better able to accept the way things work out.	.49	.48	.46	.44	.64	0.12
	22	I discovered that I'm stronger than I thought I was.	.52	.42	.47	.47	.71	0.10
	23*	I know better that I can handle difficulties.	.69	.53	.59	.46	.69	0.10

*Significant fail.

Table 4.

Correlation between Cancer-Specific Posttraumatic Growth Inventory and FACT-G (N=150)

Variables	FACT-G
	r (p)
Cancer-Specific PTGI	.45(<.001)
New possibility	.40(<.001)
Coping skill	.30(<.001)
Preciousness of life	.39(<.001)
Relating to others	.34(<.001)
Personal strength	.45(<.001)

FACT-G=Functional assessment of cancer therapy-general questionnaire; PTGI=Posttraumatic growth inventory.

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