Factors Influencing Posttraumatic Growth in Cancer Survivors

Jeong-Sook Park; You-Jeong Kim; Young-Seun Ryu; Mi-Hyang Park

doi:10.5388/aon.2018.18.1.30

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Park, Kim, Ryu, and Park: Factors Influencing Posttraumatic Growth in Cancer Survivors

Original Article

Asian Oncol Nurs 2018;18(1):30-39.

Published online: 5 March 2018

DOI: https://doi.org/10.5388/aon.2018.18.1.30

Factors Influencing Posttraumatic Growth in Cancer Survivors

Jeong-Sook Park¹, You-Jeong Kim², Young-Seun Ryu², Mi-Hyang Park³

¹College of Nursing, Keimyung University, Daegu, Korea

²College of Nursing, Graduate School of Keimyung University, Daegu, Korea

³Department of Nursing, Suseong University, Daegu, Korea

Address reprint requests to: Park, Mi-Hyang Department of Nursing, Suseong University, 15, Dalgubeol-daero 528-gil, Suseong-gu, Daegu 42078, Korea Tel: +82-53-749-7350 Fax: +82-53-749-7240 E-mail: pmhss@sc.ac.kr

Received 19 Feb 20188 Mar 2018 Accepted 26 Mar 2018

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.

초록

Purpose

The purpose of this study was to identify the level of post-traumatic growth (PTG) and the factors affecting the PTG of cancer survivors.

Methods

Data were collected from 147 cancer patients who were admitted to hospital to two hospitals, P and B city during July and September, 2017 using the PTG Inventory, Multidimensional Scale Perceived Social Support, Event-Related Rumination Inventory, Korean Cancer Coping Questionnaire, Resilience Scale, and Self-Esteem Scale. Data were analyzed using t-tests, ANOVA, Pearson-correlation coefficient, and multiple regression.

Results

The mean score for PTG in cancer survivors was 3.20 points. PTG had significant correlation with social support, deliberate rumination, coping, and resilience. Factors that had an influence on PTG in multiple regression were social support (β=0.25, p<001), personal coping (β=0.22, p=.008), resilience (β=0.21, p=.006), recognizing the need for religion (β=0.17, p=.015), religion (β=0.17 p=.011), and deliberate rumination (β=.15, p=.022). These factors explained 60.0% of the variance in the PTG of cancer patients.

Conclusion

In order to effectively promote PTG of cancer survivors, it is necessary to develop and apply programs that can improve social support, coping (personal), resilience, religion, and deliberate rumination.

Keywords: Neoplasm, Post-traumatic Stress Disorders, Social Support, Coping Behavior, Resilience

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Table 1.

Difference in Post-traumatic Growth by General Characteristics (N =147)

Variables	Categories	n (%)	M ± SD	t or F (p) Scheffé
Age (year)	25~34	6 (4.1)	56.83 ± 15.47	1.52 (.199)
	35~44	25 (17.0)	70.16 _± 19.53
	45~54	56 (38.1)	71.29 ± 21.16
	55~64	46 (31.3)	63.04 ± 22.74
	≥ 65	14 (9.5)	63.07 ± 24.62
Gender	Male	41 (27.9)	60.44 ± 23.64	-2.36 (.019)
	Female	106 (72.1)	69.74 _± 20.48
Education level	≤ Middle school ^a	18 (12.2)	55.39 ± 23.62	5.00 (.008)
	High school ^b	61 (41.5)	65.02 ± 21.35	a＜ c
	≥ College ^c	68 (46.3)	72.16 _± 20.31
Marital status	Single	14 (9.5)	57.57 ± 24.67	2.18 (.117)
	Married	109 (74.2)	69.16 ± 20.36
	Bereavement/divorce	24 (16.3)	63.58 ± 24.88
Have job	Yes	54 (36.7)	70.74 ± 20.79	1.54 (.127)
	No	93 (63.3)	65.50 ± 22.10
Average monthly	＜100 ^a	19 (12.9)	62.53 ± 17.96	4.57 (.015)
family income	100~＜300 ^b	63 (42.9)	62.59 ± 24.11	a＜ c
(10.000 won)	≥ 300 ^c	65 (44.2)	72.91 _± 19.60
Cancer insurance	Have	122 (83.0)	67.87 ± 21.27	0.89 (.373)
	Don't have	25 (17.0)	63.60 ± 24.02
Religion	Yes	93 (63.3)	74.09 ± 18.56	-5.58 (＜.001)
	No	54 (36.7)	55.19 ± 21.75
Recognizing	Absolutely needed ^a	60 (40.9)	79.97 ± 15.36	17.83 (＜.001)
the need for religion	Occasionally needed ^b	45 (30.6)	63.04 ± 21.13	a＞ b,c,d
	Not needed ^c	14 (9.5)	53.21 ± 19.23
	Not know ^d	28 (19.0)	53.21 _± 20.93
Recognizing	A lot ^a	50 (34.0)	80.92 ± 16.74	25.31 (＜.001)
religious influence	A little ^b	38 (25.9)	67.58 ± 18.56	a＞ b＞ c
	Not recognized ^c	59 (40.1)	55.19 ± 20.57
Diagnosis	Hepatobiliary-pancreatic cancer	7 (4.8)	61.00 ± 16.30	1.34 (.243)
	Thyroid cancer	10 (6.8)	78.00 ± 15.30
	Colorectal cancer	20 (13.6)	61.85 ± 25.88
	Uterine/ovary cancer	13 (8.8)	64.77 ± 23.92
	Stomach cancer	23 (15.6)	62.48 ± 26.90
	Breast cancer	61 (41.5)	71.02 ± 19.38
	Lung cancer	13 (8.9)	62.69 ± 16.98
Period elapsed	＜2	92 (62.6)	65.47 ± 22.08	1.57 (.212)
since diagnosis (year)	2~＜5	32 (21.8)	66.75 ± 23.81
	≥ 5	23 (15.6)	74.39 _± 15.90
Relapse	Yes	36 (24.5)	66.33 ± 23.15	-0.26 (.798)
	No	111 (75.5)	67.41 ± 21.36
Cancer pain	Yes	39 (26.5)	64.03 ± 23.09	-1.05 (.298)
	No	108 (73.5)	68.27 ± 21.22

Treatment method	Only surgery	21 (14.3)	66.33 ± 24.85	4.65 (.629)
	Only chemo/radiation therapy	32 (21.8)	64.13 ± 22.55
	Combination of surgery and chemo/ra	adia- 94 (63.9)	68.35 ± 20.84
	tion therapy
Cancer stage	1	45 (30.6)	71.78 ± 19.53	1.38 (.253)
	2	41 (27.9)	67.41 ± 22.73
	3	46 (31.3)	64.50 ± 22.43
	4	15 (10.2)	60.60 ± 22.23

Table 2.

Post-traumatic Growth, Social Support, Rumination, Coping, Resilience, Self-esteem

Variables	Min~Max	M ± SD	Mean score
Post-traumatic growth	9~105	67.14 ± 21.73	3.20 ± 1.03
Social support	12~60	42.76 ± 8.95	3.56 ± 0.75
Rumination
Intrusive rumination	10~40	23.22 ± 9.37	2.32 ± 0.94
Deliberate rumination	10~40	26.62 ± 7.77	2.66 ± 0.78
Coping
Personal	20~56	40.86 ± 7.27	2.92 ± 0.52
Interpersonal	9~36	26.75 ± 5.41	2.97 ± 0.60
Resilience	16~98	70.20 ± 17.60	5.01 ± 1.26
Self-esteem	13~40	27.99 ± 5.21	2.80 ± 0.52

Table 3.

Correlations between Post-traumatic Growth, Social Support, Rumination, Coping, Resilience, Self-esteem

Variables	Post-traumatic growth	Social-support	Intrusive rumination	Deliberate rumination	Coping (personal)	Coping (inter-pe,!,!rsonal)	Resilience	Self-esteem
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Social support	.56	1
	(＜.001)
Intrusive rumination	-.02	-.05	1
	(.769)	(.523)
Deliberate rumination	.46	.34	.45	1
	(＜.001)	(＜.001)	(＜.001)
Coping (personal)	.66	.48	-.06	.51	1
	(＜.001)	(＜.001)	(.496)	(＜.001)
Coping (interpersonal)	.36	.54	.07	.33	.43	1
	(＜.001)	(＜.001)	(.409)	(＜.001)	(＜.001)
Resilience	.56	.46	-.19	.23	.65	.28	1
	(＜.001)	(＜.001)	(.021)	(.004)	(＜.001)	(.001)
Self-esteem	.42	.42	-.22	.15	.42	.31	.67	1
	(＜.001)	(＜.001)	(.007)	(.071)	(＜.001)	(＜.001)	(＜.001)

Table 4.

Factors Influencing PTG in Cancer Survivors

Variables	B	SE	β	t	p
(Constant)	-21.72	7.29		-2.98	.003
Coping (personal)	0.66	0.25	.22	2.67	.008
Social support	0.61	0.15	.25	4.03	＜.001
Recognizing the need for religion*	7.31	2.96	.17	2.47	.015
Resilience	0.25	0.09	.21	2.80	.006
Religion*	7.49	2.90	.17	2.58	.011
Deliberate rumination	0.41	0.18	.15	2.32	.022
		Tolerance=.40~.71, VIF=1.41~2.50, Durbin-Watson=1.72
		Adj.R²=.60, R²=.62, F=37.60, p＜.001

PTG= Posttraumatic growth; *Dummy variables.

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