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Factors influencing posttraumatic growth in ovarian cancer survivors

Supportive Care in Cancer volume 29, pages 2037–2045 (2021)Cite this article

Abstract

Purpose

The purpose of this study was to examine posttraumatic growth (PTG), cancer coping, posttraumatic stress, and genetics knowledge among ovarian cancer survivors and to identify factors affecting PTG.

Methods

This cross-sectional study included 148 outpatient ovarian cancer survivors at a cancer center. Data were collected between February 25 and April 11, 2019, and were analyzed using t tests, ANOVA, Pearson-correlations, and multiple regression.

Results

On average, the ovarian cancer survivors scored 68.09 ± 20.17 in PTG, 59.75 ± 13.37 in cancer coping, 29.30 ± 17.25 in posttraumatic stress, and 9.42 ± 3.33 in genetics knowledge. There were significant differences in PTG according to religion (t = − 2.92, p = .004), marital status (F = 3.06, p = .050), and family history of cancer (t = 2.00, p = .047). In the final analysis, the statistically significant factors influencing PTG were religion (β = .170, p = .004) and cancer coping (β = .691, p < .001), and posttraumatic stress had borderline statistical significance (β = − .107, p < .068). These factors explained 52.2% of the variance in PTG.

Conclusions

Ovarian cancer survivors showed a moderate level of genetics knowledge while having a high risk for posttraumatic stress. Overall, this study showed that cancer coping was a powerful factor that influenced PTG in ovarian cancer survivors. Religion was found to positively affect PTG, and posttraumatic stress had a small negative effect. Spiritual nursing interventions and improving cancer coping while reducing posttraumatic stress are necessary to increase the PTG of ovarian cancer survivors.

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References

  1. Jung KW, Won YJ, Kong HJ, Lee ES (2019) Prediction of cancer incidence and mortality in Korea, 2019. Cancer Res Treat 51:431–437. https://doi.org/10.4143/crt.2019.139

    Article  PubMed  PubMed Central  Google Scholar 

  2. National Cancer Institute Office of Cancer Survivorship (2011) About survivorship research: survivorship definition. 2011. http://dccps.nci.nih.gov/ocs. Accessed 12 May 2019.

  3. Lee J, Kang E, Kim SW et al (2011) The prevalence of ovarian cancer in Korean women at high-risk for hereditary breast-ovarian cancer. J Breast Cancer 14:S24–S30. https://doi.org/10.4048/jbc.2011.14.S.S24

    Article  Google Scholar 

  4. Penar-Zadarko B, Binkowska-Bury M, Wolan M, Gawelko J, Urbanski K (2013) Longitudinal assessment of quality of life in ovarian cancer patients. Eur J Oncol Nurs 17:381–385. https://doi.org/10.1016/j.ejon.2012.10.014

    Article  PubMed  Google Scholar 

  5. Alter CL, Pelcovitz D, Axelrod A, Goldenberg B, Harris H, Meyers B, Grobois B, Mandel F, Septimus A, Kaplan S (1996) Identification of PTSD in cancer survivors. Psychosomatics 37:137–143. https://doi.org/10.1016/S0033-3182(96)71580-3

    CAS  Article  PubMed  Google Scholar 

  6. Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471. https://doi.org/10.1002/jts.2490090305

    CAS  Article  PubMed  Google Scholar 

  7. Crawford JJ, Vallance JK, Holt NL, Courneya KS (2015) Associations between exercise and posttraumatic growth in gynecologic cancer survivors. Support Care Cancer 23:705–714. https://doi.org/10.1007/s00520-014-2410-1

    Article  PubMed  Google Scholar 

  8. Jang SH, Lee HR, Yeu HN, Choi SO (2014) The effects of posttraumatic growth and meaning in life on health promotion behavior in cancer patients. Asian Oncol Nurs 14:100–108. https://doi.org/10.5388/aon.2014.14.2.100

    Article  Google Scholar 

  9. Park JH, Jung YS, Jung Y (2016) Factors influencing posttraumatic growth in survivors of breast cancer. J Korean Acad Nurs 46:454–462. https://doi.org/10.4040/jkan.2016.46.3.454

    Article  PubMed  Google Scholar 

  10. Tedeschi RG, Calhoun LG (2004) Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq 15:1–18. https://doi.org/10.1207/s15327965pli1501_01

    Article  Google Scholar 

  11. DellaRipa J, Conlon A, Lyon DE, Ameringer SA, Lynch Kelly D, Menzies V (2015) Perceptions of distress in women with ovarian cancer. Oncol Nurs Forum 42:292–300. https://doi.org/10.1188/15.ONF.292-300

    Article  PubMed  Google Scholar 

  12. Zebrack B, Kwak M, Salsman J et al (2015) The relationship between posttraumatic stress and posttraumatic growth among adolescent and young adult (AYA) cancer patients. Psychooncology 24:162–168. https://doi.org/10.1002/pon.3585

    Article  PubMed  Google Scholar 

  13. Park JS, Kim YJ, Ryu YS, Park MH (2018) Factors influencing posttraumatic growth in cancer survivors. Asian Oncol Nurs 18:30–39. https://doi.org/10.5388/aon.2018.18.1.30

    Article  Google Scholar 

  14. Song S, Ryu E (2014) Posttraumatic growth, dyadic adjustment, and quality of life in breast cancer survivors and their husbands. J Korean Acad Nurs 44:515–524. https://doi.org/10.4040/jkan.2014.44.5.515

    Article  PubMed  Google Scholar 

  15. Ha YM, Yang SK (2015) The effects of cancer-related characteristics and cancer coping on posttraumatic growth of cancer survivors. J Health Inform Stat 40:1–13

    Google Scholar 

  16. Danhauer SC, Case LD, Tedeschi R et al (2013) Predictors of posttraumatic growth in women with breast cancer. Psychooncology 22:2676–2683

    Article  Google Scholar 

  17. Romeo A, Di Tella M, Ghiggia A et al (2019) The traumatic experience of breast cancer: which factors can relate to the post-traumatic outcomes? Front Psychol 10:891. https://doi.org/10.3389/fpsyg.2019.00891

    Article  PubMed  PubMed Central  Google Scholar 

  18. Domchek SM, Friebel TM, Singer CF, Evans DG, Lynch HT, Isaacs C, Rebbeck TR (2010) Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA 304:967–975. https://doi.org/10.1001/jama.2010.1237

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  19. Seo H, Yi M (2017) A study on genetics knowledge and anxiety in patients with breast cancer. Asian Oncol Nurs 17:151–157. https://doi.org/10.5388/aon.2017.17.3.151

    Article  Google Scholar 

  20. Heidarzadeh M, Rassouli M, Mohammadi Shahbolaghi F, Alavi Majd H, Karam AM, Mirzaee H, Tahmasebi M (2014) Posttraumatic growth and its dimensions in patients with cancer. Middle East J Cancer 5:23–29

    Google Scholar 

  21. Song SH, Lee HS, Park JH, Kim KH (2009) Validity and reliability of the Korean version of the Posttraumatic Growth Inventory. Korean J Health Psychol 14:193–214. https://doi.org/10.17315/kjhp.2009.14.1.012

    Article  Google Scholar 

  22. Schultz JM, Tallman BA, Altmaier EM (2010) Pathways to posttraumatic growth: the contributions of forgiveness and importance of religion and spirituality. Psychol Relig Spiritual 2:104–114. https://doi.org/10.1037/a0018454

    Article  Google Scholar 

  23. Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160. https://doi.org/10.3758/BRM.41.4.1149

    Article  PubMed  Google Scholar 

  24. Kim JN, Kwon JH, Kim SY, Yu BH, Hur JW, Kim BS (2004) Validation of Korean-Cancer Coping Questionnaire (K-CCQ). Korean J Health Psychol 9:395–414

    Google Scholar 

  25. Moorey S, Frampton M, Greer S (2003) The Cancer Coping Questionnaire: a self-rating scale for measuring the impact of adjuvant psychological therapy on coping behaviour. Psychooncology 12:331–344. https://doi.org/10.1002/pon.646

    Article  PubMed  Google Scholar 

  26. Weiss DS, Marmar CR (1997) The Impact of Event Scale-Revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD: a practitioner’s handbook. Guilford Press, New York, pp 399–411

    Google Scholar 

  27. Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ (2005) A study on reliability and validity of the Korean version of Impact of Event Scale-Revised. J Korean Neuropsychiatr Assoc 44:303–310

    Google Scholar 

  28. Erblich J, Brown K, Kim Y, Valdimarsdottir HB, Livingston BE, Bovbjerg DH (2005) Development and validation of a breast cancer genetic counseling knowledge questionnaire. Patient Educ Couns 56:182–191. https://doi.org/10.1016/j.pec.2004.02.007

    Article  PubMed  Google Scholar 

  29. Choi KS, So HS, Tae YS et al (2006) The knowledge of hereditary breast cancer in Korean nurses. J Korean Acad Soc Nurs Educ 12:272–279

    Google Scholar 

  30. Lee SH (2019) Knowledge and anxiety related to hereditary ovarian cancer in ovarian cancer patients. Master’s Thesis, Yonsei University.

  31. Lee ES, Park JS (2013) The comparison of health promotion behavior, post traumatic growth and quality of life according to stages of survivorship in patients with female genital neoplasm. Korean J Adult Nurs 25:312–321. https://doi.org/10.7475/kjan.2013.25.3.312

    Article  Google Scholar 

  32. Dong X, Li G, Liu C, Kong L, Fang Y, Kang X, Li P (2017) The mediating role of resilience in the relationship between social support and posttraumatic growth among colorectal cancer survivors with permanent intestinal ostomies: a structural equation model analysis. Eur J Oncol Nurs 29:47–52. https://doi.org/10.1016/j.ejon.2017.04.007

    Article  PubMed  Google Scholar 

  33. Choi SH, Lee YW (2016) Influencing factors for post-traumatic growth in patients with breast cancer. J Korea Contents Assoc 16:499–509. https://doi.org/10.5392/JKCA.2016.16.11.499

    Article  Google Scholar 

  34. Lee HJ, Jun SS (2016) Factors related to posttraumatic growth in patients with colorectal cancer. Korean J Adult Nurs 28:247–255. https://doi.org/10.7475/kjan.2016.28.3.247

    Article  Google Scholar 

  35. Lee GN, Lee DS (2011) Sexual experiences of women with breast cancer. J Korean Oncol Nurs 11:210–220. https://doi.org/10.5388/jkon.2011.11.3.210

    Article  Google Scholar 

  36. Stafford L, Judd F (2011) Long-term quality of life in Australian women previously diagnosed with gynaecologic cancer. Support Care Cancer 19:2047–2056. https://doi.org/10.1007/s00520-010-1064-x

    Article  PubMed  Google Scholar 

  37. Vieweg WV, Julius DA, Fernandez A, Beatty-Brooks M, Hettema JM, Pandurangi AK (2006) Posttraumatic stress disorder: clinical features, pathophysiology, and treatment. Am J Med 119:383–390. https://doi.org/10.1016/j.amjmed.2005.09.027

    Article  PubMed  Google Scholar 

  38. Koehly LM, Peters JA, Kenen R et al (2009) Characteristics of health information gatherers, disseminators, and blockers within families at risk of hereditary cancer: implications for family health communication interventions. Am J Public Health 99:2203–2209. https://doi.org/10.2105/AJPH.2008.154096

    Article  PubMed  PubMed Central  Google Scholar 

  39. McKinney SY, Palmer RC (2014) The influence of gender on colorectal cancer knowledge, screening intention, perceived risk and worry among African Americans in South Florida. J Community Health 39:230–238. https://doi.org/10.1007/s10900-013-9812-8

    Article  PubMed  Google Scholar 

  40. Seo EY, Kwon S (2018) The influence of spiritual well-being, self-esteem, and perceived social support on post-traumatic growth among breast cancer survivors. Asian Oncol Nurs 18:232–240. https://doi.org/10.5388/aon.2018.18.4.232

    Article  Google Scholar 

  41. Denney RM, Aten JD, Leavell K (2011) Posttraumatic spiritual growth: a phenomenological study of cancer survivors. Ment Health Relig Cult 14:371–391. https://doi.org/10.1080/13674671003758667

    Article  Google Scholar 

  42. Delgado-Guay MO, Hui D, Parsons HA, Govan K, De la Cruz M, Thorney S, Bruera E (2011) Spirituality, religiosity, and spiritual pain in advanced cancer patients. J Pain Symptom Manag 41:986–994. https://doi.org/10.1016/j.jpainsymman.2010.09.017

    Article  Google Scholar 

  43. Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA (2013) The relationships among coping strategies, religious coping, and spirituality in African American women with breast cancer receiving chemotherapy. Oncol Nurs Forum 40:120–131

    Article  Google Scholar 

  44. Shin N, Kim J (2017) Experience of chemotherapy in ovarian cancer patients. Asian Oncol Nurs 17:158–169. https://doi.org/10.5388/aon.2017.17.3.158

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nursing, National Cancer Center, Graduate School of Nursing and Health Professions, Chung-Ang University, Seoul, South Korea

    Jeong Min Oh

  2. Faculty of Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjack-Gu, Seoul, 156-756, Republic of Korea

    Yoonjung Kim & Yeunhee Kwak

Authors
  1. Jeong Min Oh
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  2. Yoonjung Kim
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  3. Yeunhee Kwak
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Contributions

Study design: Jeong Min Oh and Yeunhee Kwak; data collection: Jeong Min Oh; data analysis: Jeong Min Oh; manuscript preparation: Yoonjung Kim and Yeunhee Kwak. The authors contributed equally to this work.

Corresponding author

Correspondence to Yoonjung Kim.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval and consent to participate

The survey was administered to patients who signed a written consent form. For the ethical protection of the subjects, the study was approved by the Institutional Review Board of the National Cancer Center in Korea (No. NCC2019-0023).

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Cite this article

Oh, J.M., Kim, Y. & Kwak, Y. Factors influencing posttraumatic growth in ovarian cancer survivors. Support Care Cancer 29, 2037–2045 (2021). https://doi.org/10.1007/s00520-020-05704-6

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  • DOI: https://doi.org/10.1007/s00520-020-05704-6

Keywords

  • Ovarian cancer survivor
  • Posttraumatic growth
  • Genetics knowledge
  • Posttraumatic stress
  • Cancer coping
  • Cross-sectional study