Modeling posttraumatic growth among cancer patients: The roles of social support, appraisals, and adaptive coping

Abstract

Objective The purpose of the study was to build a model to explain the relationships between social support, uncontrollability appraisal, adaptive coping, and posttraumatic growth (PTG) among cancer patients in China.Methods The participants who were cancer patients in a cancer hospital in China filled out a survey. The final sample size was 201. Structural equation modeling was used to build a model explaining PTG.Results Structural equation modeling results indicated that higher levels of social support predicted higher levels of adaptive coping, higher levels of uncontrollability appraisal predicted lower levels of adaptive coping, and higher levels of adaptive coping predicted higher levels of PTG. Moreover, adaptive coping was a mediator between social support and growth, as well as a mediator between uncontrollability and growth. The direct effects of social support and uncontrollability on PTG were insignificant. ConclusionsThe model demonstrated the relationships between social support, uncontrollability appraisal, adaptive coping, and PTG. It could be concluded that uncontrollability appraisal was a required but not sufficient condition for PTG. Neither social support nor uncontrollability appraisal had direct influence on PTG. However, social support and uncontrollability might indirectly influence PTG, through adaptive coping. It implies that both internal factors (eg, cognitive appraisal and coping) and external factors (eg, social support) are required in order for growth to happen.

Can posttraumatic growth after breast cancer promote positive coping?—A cross‐lagged study

“…Taken together with our study, there is now additional evidence that PTG may have a powerful influence on individuals' lives, even many years after experiencing a negative event, as it enhances the adaptive coping strategies in dealing with future stressors. Yet, these results contradict other findings that indicated the opposite path, where higher report of positive CER coping strategies after medical treatment of breast cancer led to an increased sense of PTG (eg,).…”

“…Studies in this field assume that coping style and cognitive processing are positively associated with one another; the coping style used in stressful events determines the level of growth that will be reported . Adaptive coping such as positive reframing, using religious belief, and working toward acceptance were found as predictors of higher levels of PTG among cancer patients (eg,—in China,—in France). Problem‐focused coping (eg,) and positive reappraisal were also found to be positively related to PTG .…”

“…Janoff‐Bulman's Shattered Assumptions Theory described how traumatic events can shatter one's views about life and meaning, the controllability of the world, as well as reliability of relationships with other people and point to the need for rebuilding a revised and viable assumptive word . In the specific context of coping with cancer, a revised set of cognitive schemas may lead patients to a better appreciation of life, to have greater satisfaction with their significant other, to feel a sense of personal strength, and to be able to take advantage of opportunities in their life they may have overlooked …”

“…9,10 In the specific context of coping with cancer, a revised set of cognitive schemas may lead patients to a better appreciation of life, to have greater satisfaction with their significant other, to feel a sense of personal strength, and to be able to take advantage of opportunities in their life they may have overlooked. 11 The current study explores two alternative paths regarding the links between coping strategies and PTG among breast cancer patients. Referring to the path between coping strategies and PTG, Tedeschi and Calhoun 4 highlighted the fact that coping processes play a significant role in the development of PTG.…”

Social relationship coping efficacy: A new construct in understanding social support and close personal relationships in persons with cancer

“…The general evidence on social support and positive personal relationships has reinforced their role in contributing to the well‐being and quality of life (QOL) of cancer patients and survivors . Social support and supportive close relationships have also been linked to positive outcomes such as posttraumatic growth, which can help sustain adjustment during cancer treatment and into survivorship . Alternatively, lack of social support can have negative effects in terms of increased cancer recurrence and mortality, and decreased QOL .…”