Supportive Care in Cancer

, Volume 27, Issue 3, pp 829–838 | Cite as

The role of post-traumatic growth in promoting healthy behavior for couples coping with cancer

  • Jung-won LimEmail author
Original Article



Post-traumatic growth (PTG) could be beneficial to cancer survivors who translate growth cognitions or emotional processes into positive behavior changes. The current study aimed to determine how post-traumatic growth (PTG) is associated with health behaviors in couples coping with cancer. Specifically, five hypothetical models based on PTG domains were created to better understand the dyadic relationship between PTG domain and health behaviors.


A total of 91 breast, colorectal, and prostate cancer survivor-spouse dyads were collected from the University Hospital Registry in Cleveland, Ohio. Standardized questions regarding PTG and health behaviors including eating and exercise were used. The actor-partner interdependence model with the use of structural equation modeling was utilized to analyze dyadic data.


Findings indicated that survivor actor effects of PTG on health behaviors were observed for survivors only. In the spiritual change and appreciation of life PTG models, the survivor or the spouse partner effects were observed, respectively. The spiritual change model produced the best fit of all of the other models, indicating both a survivor actor effect and survivor partner effect of spiritual change PTG on health behaviors. Thus, the relationships between PTG and health behavior at the dyadic level differed by five domains of PTG.


The findings reveal valuable insight into the nature of relationships between PTG and health behaviors at the individual and dyadic levels. The changed philosophies of life for cancer survivor-spouse dyads can specifically encourage healthy behaviors of couples coping with cancer.


Cancer survivor Dyadic relationships Health behavior Post-traumatic growth 



This work was supported by Kangnam University Research Grant.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Jones (2014) Survivorship care plans: where are we now? Oncology Exchange 13:14–17Google Scholar
  2. 2.
    Faul et al (2012) Survivorship care planning in colorectal cancer: feedback from survivors & providers. J Psychosoc Oncol 30:198–216Google Scholar
  3. 3.
    Institute of Medicine (2006) From cancer patient to cancer survivor: lost in transition. The National Academies Press, Washington DCGoogle Scholar
  4. 4.
    Stanton, Bower, Low (2006) Posttraumatic growth after cancer. In: Calhoun LG, Tedschi RG (eds) Handbook of posttraumatic growth: research & practice. Lawrence Erlbaum associates publishers, Mahwah, pp 138–175Google Scholar
  5. 5.
    Kim, Carver, Cannady (2015) Caregiving motivation predicts long-term spirituality and quality of life of the caregivers. Ann Behav Med 49:500–509Google Scholar
  6. 6.
    Kim, Given (2008) Quality of life of family caregivers of cancer survivors. Cancer 112(S11):2556–2568Google Scholar
  7. 7.
    Hagedoorn, Sanderman, Bolks, Tuinstra, Coyne (2008) Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psychol Bull 134:1–30Google Scholar
  8. 8.
    Lim, Shon, Paek, Daly (2014) The dyadic effects of coping and reslience on psychological distress for cancer survivor couples. Support Care Cancer 22(12):3209–3217Google Scholar
  9. 9.
    Rajandram, Jenewein, McGrath, Zwahlen (2011) Coping processes relevant to posttraumatic growth: an evidence-based review. Support Care Cancer 19:583–589Google Scholar
  10. 10.
    Taylor (1983) Adjustment to threatening events: a theory of cognitive adaptation. Am Psychol 38:1161–1173Google Scholar
  11. 11.
    Tedeschi & Calhoun, eds. A surprise attack, a surprise result: posttraumatic growth through expert companionship. In: G.W. Burns ed. Happiness, healing, enhancement: your casebook collection for applying positive psychology in therapy. 2010, Wiley: Hoboken 226–236Google Scholar
  12. 12.
    Svetina, Nastran (2012) Family relationships and post-traumatic growth in breast cancer patients. Psychiatr Danub 24(3):298–306Google Scholar
  13. 13.
    Rinaldis, Pakenham, Lynch (2010) Relationships between quality of life and finding benefits in a diagnosis of colorectal cancer. Br J Psychol 101:259–275Google Scholar
  14. 14.
    Jansen, Hoffmeister, Chang-Claude, Brenner, Arndt (2011) Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Br J Cancer 105:1158–1165Google Scholar
  15. 15.
    Thornton (2002) Perceiving benefits in the cancer experience. J Clin Psychol Med Settings 9:153–165Google Scholar
  16. 16.
    Zwahlen, Hagenbuch, Carley, Jenewein, Buchi (2010) Posttraumatic growth in cancer patients and partners--effects of role, gender and the dyad on couples’ posttraumatic growth experience. Psychooncology 19(1):12–20Google Scholar
  17. 17.
    Silva, Crespo, Canavarro (2012) Pathways for psychological adjustment in breast cancer: a longitudinal study on coping strategies and posttraumatic growth. Psychol Health 27(11):1323–1341Google Scholar
  18. 18.
    Deci, Ryan (2000) The ‘what’ and ‘why’ of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 11(4):227–268Google Scholar
  19. 19.
    Shakespeare-Finch, Barrington (2012) Behavioural changes add validity to the construct of posttraumatic growth. J Trauma Stress 25(4):433–439Google Scholar
  20. 20.
    Morris, Shakespeare-Finch, Scott (2012) Posttraumatic growth after cancer: the importance of health-related benefits and newfound compassion for others. Support Care Cancer 20(4):749–756Google Scholar
  21. 21.
    Hefferon, Grealy, Mutrie (2009) Post-traumatic growth and life threatening physical illness: a systematic review of the qualitative literature. Br J Health Psychol 14(Pt 2):343–378Google Scholar
  22. 22.
    Ryan (2009) Integrated theory of health behavior change: background and intervention development. Clin Nurse Spec 23(3):161–172Google Scholar
  23. 23.
    Tedeschi, Calhoun (1996) The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471Google Scholar
  24. 24.
    Kenny, Kashy, Cook (2006) Dyadic data analysis. Guilford Press, New YorkGoogle Scholar
  25. 25.
    Cann et al (2010) A short form of the posttraumatic growth inventory. Anxiety Stress Coping 23(2):127–137Google Scholar
  26. 26.
    Tambling, Johnson, Johnson (2011) Analyzing dyadic data from small samples: a pooled regression actor-partner interdependence model approach. CORE 2(2):101–114Google Scholar
  27. 27.
    Ledermann, Macho, Kenny (2011) Assessing mediation in dyadic data using the actor-partner interdependence model. Struct Equ Model 18:595–612Google Scholar
  28. 28.
    Enders, Bandalos (2001) The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Struct Equ Model 8(3):430–457Google Scholar
  29. 29.
    Sarfati, Koczwara, Jackson (2016) The impact of comorbidity on cancer and its treatment. CA Cancer J Clin 66(4):337–350Google Scholar
  30. 30.
    Manne et al (2014) Unsupportive partner behaviors, social-cognitive processing, and psychological outcomes in couples coping with early stage breast cancer. J Fam Psychol 28(2):214–224Google Scholar
  31. 31.
    Steiger (1990) Structural model evaluation and modification: an interval estimation approach. Multivar Behav Res 25:173–180Google Scholar
  32. 32.
    Bentler (1990) Comparative fix indexes in structural models. Psychol Bull 107(2):238–246Google Scholar
  33. 33.
    Ramos, Leal (2013) Posttraumatic growth in the aftermath of trauma: a literature review about related factors and application contexts. PCH 2(1):43–54Google Scholar
  34. 34.
    Prati, Pietrantoni (2009) Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: a meta-analysis. J Loss Trauma 14(5):5364–5388Google Scholar
  35. 35.
    Litzelman, Green, Yabroff (2016) Cancer and quality of life in spousal dyads: spillover in couples with and without cancer-related health problems. Support Care Cancer 24(2):763–771Google Scholar
  36. 36.
    Girgis, Lambert, Johnson, Waller, Currow (2013) Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review. J Oncol Pract 9(4):197–202Google Scholar
  37. 37.
    Maleknia, Kahrazei (2015) The relationship between stress coping styles and quality of life among patient with breast cancer. JMRH 3(4):472–478Google Scholar
  38. 38.
    Krause (2005) God-mediated control and psychological well-being in late life. Psychol Aging 13:553–562Google Scholar
  39. 39.
    Rabinowitz, Mausbach, Atkinson, Gallagher-Thompson (2009) The relationship between religiosity and health behaviors in female caregivers of older adults with dementia. Aging Ment Health 13(6):788–798Google Scholar
  40. 40.
    Cadell, Suarez, Hemsworth (2015) Reliability and validity of a french version of the posttraumatic growth inventory. OJMP 4:53–65Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.College of Social WelfareKangnam UniversityYongin-siSouth Korea

Personalised recommendations