Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer

Hyeon Ju Lee; Seong Sook Jun

doi:10.7469/kjan.2016.28.3.247

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Lee and Jun: Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer

Original Article

Korean J Adult Nurs 2016;28(3):247-255.

Published online: June 2016

DOI: https://doi.org/10.7469/kjan.2016.28.3.247

Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer

Hyeon Ju Lee¹, Seong Sook Jun²

^¹Pusan National University Yangsan Hospital, Yangsan

^²College of Nursing, Pusan National University, Yangsan, Korea

Corresponding author: Jun, Seong Sook College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-51-510-8358, Fax: +82-51-510-8308, E-mail: jss@pusan.ac.kr

Received 30 January 20169 April 2016 Accepted 17 June 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the influencing factors on Posttraumatic Growth(PTG) in patients with colorectal cancer.

Methods

Eighty patients who were diagnosed with colorectal cancer at least twelve months ago were recruited from the oncology outpatient clinic of university hospital in Y city. Participants completed four survey questionnaires: Korean versions of PTG Index, Korean versions of Cancer Coping Questionnaire, Multidimensional Scale of Perceived Social Support, and a Resilience Scale. The data were analyzed by ANOVA, Pearson-correlation coefficient, and multiple regression analysis.

Results

The mean score of PTG in these patients was 51.16 indicating relatively high growth. Posttraumatic Growth had significant correlations with coping, social support, and resiliency. In addition to the variables of age and education that are found to be associated with the PTG, the PTG was significantly influenced by resilience, coping, and importance of religion. Forty-nine percent of the variations in the PTG were explained by these three variables.

Conclusion

The identified factors influencing colorectal cancer related to PTG could be considered in developing nursing interventions to promote positive psychological changes in response to adversity which colorectal cancer survivors might experience.

Keywords: Trauma, Colorectal cancer, Coping behavior, Social support, Resilience

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Table 1.

Status of Posttraumatic Growth and related Factors in Patients with Colorectal Cancer (N=80)

Variables	M±SD	Range
Posttraumatic growth	51.16±14.04	0~80
Personal strength	20.55±5.45	0~30
Relating to others	16.09±4.72	0~25
New possibilities	9.49±3.39	0~15
Spiritual change	5.04±2.59	0~10
Coping	54.43±12.75	23~92
Interpersonal	21.95±6.93	9~36
Individual	32.48±7.81	14~56
Positive focus	15.88±4.07	6~24
Coping	10.30±2.95	5~20
Planning	6.30±2.35	3~12
Social support	40.93±7.96	12~60
Significant others	10.61±4.71	4~20
Family	16.40±2.66	4~20
Friends	13.91±3.46	4~20
Resilience	99.10±12.36	27~135
Cause analytical	11.36±1.82	3~15
Emotion control	11.12±2.08	3~15
Urges restraint	11.35±1.82	3~15
Gratitude	11.15±2.26	3~15
Life satisfaction	9.98±2.37	3~15
Optimism	11.85±1.76	3~15
Relationship	11.56±2.41	3~15
Communication	10.09±2.38	3~15
Empathy	10.64±2.03	3~15

Table 2.

Difference in Posttraumatic Growth based on Sociodemographic and Disease related Characteristics (N=80)

Characteristics	Categories	n (%)	M±SD	t or F	p	Scheffé
Gender	Male	46 (57.5)	50.5±13.65	-0.51	.611
Gender	Female	34 (42.5)	51.1±14.73
Age (year)	≤49^a	19 (23.8)	58.6±10.34	4.01	.011	a＞b
	50~59^b	18 (22.5)	43.8±15.09
	60~69^c	26 (32.5)	52.1±10.83
	≥70^d	17 (21.2)	49.2±17.17
Marital status	Single	6 (7.5)	48.7±3.33	2.58	.083
	Married	60 (75.0)	53.1±14.11
	Separation	14 (17.5)	44.0±14.70
Number of children	0	12 (15.0)	49.0±12.12	1.64	.186
	1	9 (11.2)	42.9±18.48
	2	35 (43.8)	54.0±13.38
	≥3	24 (30.0)	51.3±14.50
Education completed	≤Middle school^a	20 (25.0)	49.8±13.37	3.48	.036	b＜c
	High school^b	38 (47.5)	48.2±13.72
	≥College^c	22 (27.5)	57.6±13.67
Job	No	56 (70.0)	51.1±14.72	0.04	.967
Job	Yes	24 (30.0)	51.3±12.64
Income	No	49 (61.3)	50.4±15.01	-0.59	.560
Income	Yes	31 (38.7)	52.3±12.32
Religion	No	24 (30.0)	48.6±15.09	0.65	.629
Religion	Yes	56 (70.0)	52.3±13.57
Importance of religion	Not important^a	25 (31.3)	44.4±13.85	4.70	.012	a＜b
	A little important^b	39 (48.8)	54.6±11.29
	Very important^c	16 (20.0)	53.3±17.22
Character	Extrovert	29 (36.3)	55.6±11.84	2.17	.033
Character	Introvert	51 (63.7)	48.6±14.82
Cancer stage	I	1 (1.3)	52.0	0.59	.621
	II	10 (12.5)	54.9±7.77
	III	44 (55.0)	49.3±14.29
	IV	25 (31.2)	52.8±15.67
Therapy method	Surgery	7 (8.8)	48.1±11.02	1.19	.320
	Surgery+chemo	52 (65.0)	49.6±14.27
	Surgery+chemo+radiation	19 (23.8)	56.2±13.92
	Other	2 (2.5)	55.0±16.97
Ostomy	Yes	10 (12.5)	49.2±13.39	0.01	.929
Ostomy	No	70 (87.5)	51.4±14.21

Table 3.

Correlational Relationships among Major Variables (N=80)

Variables	PTG	PTG; Personal strength	PTG; Relating to others	PTG; New possibilities	PTG; Spiritual change
Variables	r (p)	r (p)	r (p)	r (p)	r (p)
Coping	.55 (＜.001)	.49 (.001)	.49 (＜.001)	.58 (＜.001)	.31 (.005)
Social support	.34 (＜.001)	.36 (.001)	.29 (.009)	.26 (.018)	.23 (.037)
Resilience	.42 (＜.001)	.52 (＜.001)	.40 (＜.001)	.33 (.003)	.05 (.653)

PTG=posttraumatic growth.

Table 4.

Factors related to Posttraumatic Growth in Patients with Colorectal Cancer (N=80)

Variable	B	SE	β	t	p	VIF
Resilience	0.48	0.11	.46	5.18	＜.001	1.187
Coping	0.35	0.11	.34	3.82	＜.001	1.224
Importance of religion (A little important)	7.20	2.72	.19	2.31	.024	1.043
Importance of religion (Very important)	4.98	3.33	.14	1.49	.139	1.398
Age	-0.05	0.12	-.04	-0.36	.718	1.606
Education completed (High school)	-3.25	2.95	-.12	-1.10	.274	1.707
Education completed (College and above)	0.93	3.69	.03	0.25	.801	2.138
Social support	0.01	0.17	.42	0.04	.967	1.407
	Adj. R²=.48.4, F=10.270, p＜.001, Durbin-Watson=2.07

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