Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope

Document Type: Original Article

Authors

1 Student research committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

2 Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Cancer not only is a traumatic experience for the patients, but also can affect the family
caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by
people as a result of a struggle in dealing with traumatic events in life. Both the patients and their
caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of
patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and
both the social support (SS) and hope.
Methods: The present descriptive correlational study was conducted during May-August 2018 in
Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz
University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic
information form, post-traumatic growth inventory, social support appraisals scale, and Miller
hope scale. The data were analyzed using the SPSS software (version 23.0). Pstatistically significant.
Results: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84,
respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59)
and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant
relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62)
compared to SS (ẞ=0.27).
Conclusion: The results showed a good level of PTG among the caregivers and the experience of
stressful situations positively affected their psychological condition. The positive change was associated
with the perceived SS and hope.

Keywords


 

  1. Wadhwa D, Burman D, Swami N, et al. Quality of life and mental health in caregivers of outpatients with advanced cancer. Psycho-oncology. 2013;22:403-10.
  2. Fletcher BS, Miaskowski C, Given B, Schumacher K. The cancer family caregiving experience: an updated and expanded conceptual model. European Journal of Oncology Nursing. 2012;16:387-98.
  3. Segrin C, Badger TA, Harrington J. Interdependent psychological quality of life in dyads adjusting to prostate cancer. Health Psychology. 2012;31:70-9.
  4. Moser MT, Künzler A, Nussbeck F, et al. Higher emotional distress in female partners of cancer patients: prevalence and patient–partner interdependencies in a 3-year cohort. Psycho-oncology. 2013;22:2693-701.
  5. Cormio C, Muzzatti B, Romito F, et al. Posttraumatic growth and cancer: a study 5 years after treatment end. Support Care Cancer. 2017;25:1087-96.
  6. Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress. 1996;9:455-71.
  7. Tedeschi RG, Park CL, Calhoun LG. Posttraumatic growth: Positive changes in the aftermath of crisis. 1st ed. USA: Lawrence Erlbaum; 1998.
  8. Fallah R, Keshmir F, Lotfi*Kashani F, et al. Post-traumatic Growth in Breast Cancer patients: A Qualitative Phenomenological Study. Middle East Journal of Cancer. 2012;3:35-44.
  9. Balfe M, O’ Brien K, Timmons A, et al. What factors are associated with posttraumatic growth in head and neck cancer carers? European Journal of Oncology Nursing. 2016;21:31-7.
  10. Arpawong TE, Oland A, Milam JE, et al. Post-traumatic growth among an ethnically diverse sample of adolescent and young adult cancer survivors. Psycho-oncology. 2013;22:2235-44.
  11. Salimie-Bajestani H, Shafieaabadi A, Etemadi A, Ahmadi KH. A comparison of the effectiveness of Adlerian counseling and cognitive reconstruction based on an allegory of student mental health. Journal of Behavioral Sciences. 2012;6:237-43. [In Persian]
  12. Rosenberg AR, Baker KS, Syrjala KL, et al. Promoting Resilience among Parents and Caregivers of Children with Cancer. Journal of Palliative Medicine. 2013;16:645-52.
  13. Cormio C, Romito F, Viscanti G, et al. Psychological well-being and posttraumatic growth in caregivers of cancer patients. Frontiers in Psychology. 2014;5:1342.
  14. Cao W, Qi X, Cai DA, Han X. Modeling posttraumatic growth among cancer patients: the roles of social support, appraisals, and adaptive coping. Psycho-oncology. 2018;27:208-15.
  15. Sharma A, Zhang J. Predictors of post traumatic growth among breast cancer patients in Nepal. Asian Pacific Journal of Health Sciences. 2017;4:9-17.
  16. Heidarzadeh M, Dadkhah B, Gholchin M. Post-traumatic growth, hope, and depression in elderly cancer patients. International Journal of Medical Research & Health Sciences. 2016;5:455-61.
  17. Nenova M, DuHamel K, Zemon V, et al. Posttraumatic growth, social support, and social constraint in hematopoietic stem cell transplant survivors. Psycho-oncology. 2013;22:195-202.
  18. Thornton AA, Perez MA. Posttraumatic growth in prostate cancer survivors and their partners. Psycho-oncology. 2006;15:285-96.
  19. Zwahlen D, Hagenbuch N, Carley MI, et al. Posttraumatic growth in cancer patients and partners-effects of role, gender and the dyad on couples’ posttraumatic growth experience. Psycho-oncology. 2010;19:12-20.
  20. Rahimi R, Heidarzadeh M, Shoaee M. The Relationship between Posttraumatic Growth and Social Support in Patients with Myocardial Infarction. Canadian Journal of Cardiovascular Nursing. 2016;26:19-24.
  21. Scioli A, Biller H. The power of hope. Deerfield Beach (USA): Health Communication; 2010.
  22. Hullmann SE, Fedele DA, Molzon ES, et al. Posttraumatic growth and hope in parents of children with cancer. Journal of Psychosocial Oncology. 2014;32:696-707.
  23. Nisa SU, Saggu TK. To estimate the efficacy of 0.1% tacrolimus with Colgate Oraguard-B paste for the treatment of patients with symptomatic oral lichen planus. Indian Journal of Dentistry. 2016;7:23-7.
  24. Tanriverd D, Savas E, Can G. Posttraumatic growth and social support in Turkish patients with cancer. Asian Pacific Journal of Cancer Prevention. 2012;13:4311-4.
  25. Heidarzadeh M, Rassouli M, Mohammadi F, et al. Posttraumatic Growth and its Dimensions in Patients with Cancer. Middle East Journal of Cancer. 2014;5:23-9.
  26. Vaux A, Phillips J, Holly L, et al. The social support appraisals (SS-A) scale: Studies of reliability and validity. American Journal of Community Psychology. 1986;14:195-218.
  27. Charkhian A, Fekrazad H, Sajadi H, et al. Relationship between health-related quality of life and social support in HIV-infected people in Tehran, Iran. Iranian Journal of Public Health. 2014;43:100-6.
  28. Miller JF, Powers MJ. Development of an instrument to measure hope. Journal of Nursing Research. 1988;37:6-10.
  29. Abdi N, Asadi-Lari M. Standardization of Three Hope Scales, as Possible Measures at the End of Life, in Iranian Population. Iranian Journal of Cancer Prevention. 2011;4:71-7.
  30. Dasht*Bozorgi Z, Homai R. The Relationship between Self-compassion, Social Support and Hope with Persecution of Nursing Students. Education Strategies inMedical Sciences. 2018;11:126-32. [In Persian]
  31. Lopez SJ, Snyder CR. The Oxford Handbook of Positive Psychology. 2nd ed. New York: Oxford University Press; 2009.
  32. Heydarzade M, Rassouli M, Mahmudi-shahbalaghi F, et al. Assessing dimensions of posttraumatic growth of cancer in survived patients. Comprehensive Nursing and Midwifery. 2015;25:33-41. [In Persian]
  33. Farsi Z, Dehghan*Nayeri N, Negarandeh R. Coping strategies of adults with leukemia undergoing hematopoietic stem cell transplantation in Iran: a qualitative study. Nursing & Health Sciences. 2010;12:485-92.
  34. Hung HC, Tsai MC, Chen SC, et al. Change and Predictors of Social Support in Caregivers of Newly Diagnosed Oral Cavity Cancer Patients During the First 3 Months After Discharge. Cancer Nursing. 2013;36:E17-24.
  35. Shakiba A, Bahrami F, Farsani*Zabiholah K. The Study of the Factorial Structure and Psychometric Properties of the Auckland Individualism- Collectivism Scale. Knowledge & Research in Applied Psychology. 2011;12:20-30. [In Persian]
  36. Haghshenas L. The mediating role of social support in predicting general health based on emotional control in mothers of children with cancer. Contemporary Psychology. 2017;12:85-98. [In Persian]
  37. Rajandram RK, Jenewein J, McGrath C, Zwahlen RA. Coping processes relevant to posttraumatic growth: an evidence based review. Support Care Cancer. 2011;19:583-9.
  38. Morris BA, Chambers SK, Campbell M, et al. Motorcycles and breast cancer: The influence of peer support and challenge on distress and posttraumatic growth. Support Care Cancer. 2011;20:1849-58.
  39. Shin SH, Lee S. Caregiver social support for children involved with child welfare: correlates and racial/ethnic variations. Journal of Public Child Welfare. 2011;5:349-68.
  40. Pamukçu B, Meydan B. The role of empathic tendency and perceived social support in predicting loneliness levels of college students. Procedia-Social and Behavioral Sciences. 2010;5:905-9.
  41. Pehlivan S, Ovayolu O, Ovayolu N, et al. Relationship between hopelessness, loneliness, and perceived social support from family in Turkish patients with cancer. Supportive Care Cancer. 2012;20:733-9.