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Post-traumatic growth and its influencing factors among Chinese women diagnosed with gynecological cancer: A cross-sectional study
School of Nursing, Anhui Medical University, Shu Shan District, He Fei City, Anhui Province, China.ORCID iD: 0000-0002-6792-9901
School of Nursing, Anhui Medical University, Shu Shan District, He Fei City, Anhui Province, China.
The First Affiliated Hospital of Anhui Medical University, Shu Shan District, He Fei City, Anhui Province, China.
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
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2021 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 51, article id 101903Article in journal (Refereed) Published
Abstract [en]

Purpose: The experience of cancer could lead to positive psychological changes following the struggle with diagnosis and treatment. Understanding post-traumatic growth and its influencing factors in women affected by gynecological cancer is essential to enhance their possibility of achieving positive changes. The purpose of this study was to describe the post-traumatic growth level and explore the influencing factors of post-traumatic growth in Chinese women diagnosed with gynecological cancer. Method: A cross-sectional survey with a convenience sampling method was employed to collect data using the Post-traumatic Growth Inventory (PTGI), Distress Disclosure Index (DDI), Medical Coping Modes Questionnaire (MCMQ), and Multidimensional Scale of Perceived Social Support (MSPSS). The questionnaires were administered to 344 participants recruited from two hospitals in Hefei City, the capital of Anhui Province in China, between March 2018 and March 2019. All statistical analyses were performed using nonparametric tests. The Mann-Whitney U Test was used to distinguish the intergroup differences. Correlations were evaluated with Spearman rank correlation coefficients. Results: Total score for PTGI was 56.5 (range 48.0–68.0). The subscale with the highest centesimal score in the PTGI was appreciation of life and the lowest was spiritual change. The top five items with the highest scores of PTGI belonged to appreciating life, personal strength, and relating to others. Self-disclosure, confrontation, avoidance, acceptance-resignation, perceived social support, education level, cancer type and the place they lived had significant influence on post-traumatic growth. Conclusions: The findings indicate that women who have high levels of perceived social support, confrontation, avoidance, self-disclosure and education level tend to experience more post-traumatic growth, while, conversely, high levels of acceptance-resignation have a negative influence on promoting post-traumatic growth. These meaningful findings propose new perspectives for promoting post-traumatic growth in Chinese women diagnosed with gynecological cancer.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 51, article id 101903
Keywords [en]
Coping strategies, Gynecological cancer, Perceived social support, Post-traumatic growth, Self-disclosure
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-51995DOI: 10.1016/j.ejon.2021.101903ISI: 000635184400004PubMedID: 33618228Scopus ID: 2-s2.0-85101132435Local ID: ;intsam;726169OAI: oai:DiVA.org:hj-51995DiVA, id: diva2:1535202
Available from: 2021-03-08 Created: 2021-03-08 Last updated: 2023-04-26Bibliographically approved
In thesis
1. Perceived growth following gynecological cancer and its associated factors from the perspectives of Chinese women, spouses, couples and registered nurses
Open this publication in new window or tab >>Perceived growth following gynecological cancer and its associated factors from the perspectives of Chinese women, spouses, couples and registered nurses
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Gynecological cancer (GC) is the most common cancer diagnosis among women, globally, including China. Women who experience a diagnosis of GC, their spouses, the couples as a unit, as well as registered nurses (RNs) caring for these women, all face different challenges during this cancer trajectory. Prior to this study, few studies have explored the factors associated with perceived growth among women diagnosed with GC, their spouses, and couples, as well as RNs caring for these women, based on a growth-related theory and model. The overall aim of this thesis was therefore to explore perceived growth and its associated factors, based on these persons’ perspectives.

Four studies (Study I–IV) ) were conducted, each using a cross-sectional and descriptive study design. In Study I, women’s posttraumatic growth (PTG) and its associated factors were explored. Data were collected through 344 questionnaires and analyzed by using binary stepwise logistic regression. In Study II, spouses’ PTG and its associated factors were explored. Data were collected through 312 questionnaires and analyzed by using multiple regression analysis. Study III explored the actor effects and partner effects of perceived social support on PTG among couples where the woman had been diagnosed with GC. Data were collected with 126 couples using questionnaires and analyzed by using Structural Equation Modeling. Study IV described the perceived professional benefits and explored the association between perceived professional benefits, sense of coherence, and coping strategies in RNs caring for women diagnosed with GC. Data were collected with 250 RNs using questionnaires and analyzed by using multiple regression analysis.

The results indicate that women’s self-disclosure was positively associated with their PTG. Confrontation coping strategies, avoidance coping strategies, problem-focused coping strategies (e.g., active coping, instrumental support, and planning), and dysfunctional coping (e.g., denial, behavioral disengagement, self-distraction, and venting) were positively associated with perceived growth. Perceived social support was positively associated with PTG in both women diagnosed with GC and their spouses. Spouses’ perceived social support was positively associated with women’s perceived social support and women’s PTG. In addition, sense of coherence was positively associated with RNs’ perceived professional benefits.

Based on the findings from this thesis, it is concluded that RNs need to encourage these women and their spouses to communicate their feelings, concerns, and supportive care needs, with other family members and loved ones. RNs also needs to pay more attention to the spouses’ supportive care needs, so that they are able to better support these women. It was shown that integrating effective coping strategies into existing cancer care practice may help couples to cope with the challenges related to GC. Furthermore, RNs should consider women and their spouses as a whole unit to provide effective care, and to help couples as a unit to re-evaluate their understanding of what really matters in their life. In addition, there is a need to help RNs to promote the nurse–patient relationship and a sense of belonging to the work team in their nursing practice.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2023. p. 100
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 126
Keywords
Coping strategies, gynecological cancer, perceived professional benefits, posttraumatic growth, self-disclosure, sense of coherence, social support
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-60257 (URN)978-91-88669-27-8 (ISBN)978-91-88669-28-5 (ISBN)
Public defence
2023-06-01, Ga 626 Antarktis, Jönköping, 13:00 (English)
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Supervisors
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-04-26Bibliographically approved

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Zhou, LihuaHenricson, MariaBrowall, MariaEnskär, Karin

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