Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors

Bower, Julienne E.; Meyerowitz, Beth E.; Desmond, Katherine A.; Bernaards, Coen A.; Rowland, Julia H.; Ganz, Patricia A.

doi:10.1207/s15324796abm2903_10

Cited by 247 publications

(232 citation statements)

References 42 publications

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“…These include enhanced self-esteem, greater life appreciation and meaning, heightened spirituality, and greater feelings of peace and purposefulness. 32,43,44 These positive long-term or late effects can be viewed as benefits of cancer diagnosis and treatment and are often characterized as posttraumatic growth. [45][46][47][48] Finally, although we have drawn a distinction between 'long-term' and 'late' psychological effects, the research literature generally has not.…”

Section: Psychological Long-term and Late Effects Of Cancermentioning

confidence: 99%

Physical and psychological long-term and late effects of cancer

Stein

Syrjala

Andrykowski

2008

Cancer

591

415

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The number of long-term cancer survivors (5 years after diagnosis) in the U.S.continues to rise, with more than 10 million Americans now living with a history of cancer. Along with such growth has come increasing attention to the continued health problems and needs of this population. Many cancer survivors return to normal functioning after the completion of treatment and are able to live relatively symptom-free lives. However, cancer and its treatment can also result in a wide range of physical and psychological problems that do not recede with time.Some of these problems emerge during or after cancer treatment and persist in a chronic, long-term manner. Other problems may not appear until months or even years later. Regardless of when they present, long-term and late effects of cancer can have a negative effect on cancer survivors' quality of life. This article describes the physical and psychological long-term and late effects among adult survivors of pediatric and adult cancers. The focus is on the prevalence and correlates of long-term and late effects as well as the associated deficits in physical and emotional functioning. In addition, the emergence of public health initiatives and large-scale research activities that address the issues of long-term cancer survivorship are discussed. Although additional research is needed to fully understand and document the long-term and late effects of cancer, important lessons can be learned from existing knowledge. Increased awareness of these issues is a key component in the development of follow-up care plans that may allow for adequate surveillance, prevention, and the management of long-term and late effects of cancer. T he number of long-term cancer survivors (5 years after diagnosis) in the U.S. is increasing because of advances in cancer screening, early detection, treatment strategies, and management of acute treatment toxicities. Indeed, the 5-year survival rate for all cancers combined has risen to 66%, up from approximately 50% in the 1970s, 1 and it is estimated that there are now more than 10 million Americans living with a history of cancer.2 Furthermore, based partly on the overall growth and increasing average age of the U.S. population, researchers are predicting that the number of persons over the age of 65 years diagnosed with cancer each year will double by the year 2050, and will quadruple among those aged 85 years in the same time frame.3 Considered together, these factors suggest that the number of cancer survivors in this country will continue to grow and that their long-term heath problems and resulting needs will demand increasing attention.

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Section: Psychological Long-term and Late Effects Of Cancermentioning

confidence: 99%

Physical and psychological long-term and late effects of cancer

Stein

Syrjala

Andrykowski

2008

Cancer

591

415

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“…Some 20 scales were identified that measured meaning: the Chinese Cancer Coherence Scale (CCCS) (Chan et al, 2007); the Constructed Meaning Scale (Fife, 1995); the meaning/peace subscale of the Functional Assessment of Chronic Illness Therapy -Spiritual Well-Being Scale (FACIT-Sp) (Canada et al, 2008;Murphy et al, 2010;Peterman et al, 2002); the Illness Cognitions Questionnaire (ICQ) (Evers et al, 2001); the Internal Coherence Scale (ICS) (Kroz et al, 2009); the Life Attitude Profile (LAP)/ Life Attitude Profile -Revised (LAP -R) (Reker, 1992;Reker & Peacock, 1981); the Life Evaluation Questionnaire (LEQ) (Salmon et al, 1996); the Meaning in Life questions (including the Benefit Finding Scale [BFS]) used by Tomich and Helgeson (2002); the Meaning in Life Questionnaire (MLQ) (Steger et al, 2006); the Meaning in Life Scale (MILS) (Jim et al, 2006); the Meaning in Suffering Test (MIST) (Starck, 1983); the Perceived Meanings of Cancer Pain Inventory (PMCPI) (Chen, 1999); the Personal Meaning Profile (PMP) (Wong, 1998); the Positive Meaning and Vulnerability Scale (Bower et al, 2005); the Purpose in Life (PIL) Test (Crumbaugh & Maholick, 1964); the Purposelessness, Understimulation, and Boredom (PUB) Scale (Passik et al, 2003); the Schedule for Meaning in Life Evaluation (SMiLE) (Fegg et al, 2008); the Sense of Coherence (SOC) Scale (Antonovsky, 1993); the Sources of Meaning Profile (SOMP)/Sources of Meaning Profile -Revised (SOMP -R) (Reker, 1996); and the World Assumptions Scale (Janoff-Bulman, 1989). The optimal measure of meaning will vary depending on the purpose and context of the assessment.…”

Section: Meaningmentioning

confidence: 99%

Assessment of spiritual suffering in the cancer context: A systematic literature review

et al. 2014

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Objective: An important goal of cancer medicine is relief of patients' suffering. In view of the clinical challenges of identifying suffering patients, we sought to identify valid instruments for assessing the spiritual suffering of people diagnosed with cancer.Method: A systematic review of the literature was conducted in the Medline, Embase, the Cochrane Library, and PsycINFO databases seeking assessment instruments that measure either suffering or one of its synonyms or symptoms. The psychometric properties of the identified measures were compared.Results: A total of 90 articles were identified that supplied information about 58 measures. The constructs examined were: suffering, hopelessness/demoralization, hope, meaning, spiritual well-being, quality of life where a spiritual/existential dimension was included, distress in the palliative care setting and pain, distress or struggle of a spiritual nature. The Pictorial Representation of Illness and Self Measure (PRISM) (patient completed) was the most promising measure identified for measuring the burden of suffering caused by illness due to its ease of use and the inclusion of a subjective component.Significance of Results: Although the appropriateness of any measure for the assessment of spiritual suffering in cancer patients will depend on the context in which it is intended to be utilized, the PRISM is promising for measuring the burden of suffering due to illness.

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“…Further, the experience of stress-related growth decreases distress in cancer survivors (Bower et al, 2005;Morrill et al, 2008). Lower distress following growth might be relevant for individuals who have experienced earlier life stress along with previous growth.…”

Section: Stress-related Growth After Cancermentioning

confidence: 99%

Distress and Resilience After Cancer in Veterans

Jahn

Herman

Schuster

et al. 2012

Research in Human Development

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Combat exposure and posttraumatic stress have the potential to affect distress in response to cancer, a common late-life stressor. Models of posttraumatic growth suggest that distress can produce varying avenues for resilience. A primarily male, veteran sample completed interviews regarding how combat exposure and posttraumatic stress relate to distress and growth in cancer survivors. While combat alone did not predict greater distress, combat veterans with current combat-related posttraumatic stress symptoms reported the greatest distress following cancer. These same veterans showed cancer-related growth. This is the first large-scale study examining the relationships among combat, posttraumatic stress, and emotional health following cancer.What is the lifespan developmental impact of combat trauma? Does early life exposure to combat increase the risk of distress when confronted with later life-threatening illness, or does survival following such exposure convey resilience? Combat exposure is associated with the risk of developing posttraumatic stress disorder (PTSD) (Aldwin, Levenson, & Spiro, 1994;Fontana & Rosenheck, 1998;Lee, Vaillant, Torrey, & Elder, 1995). At the same time, combat exposure may be associated with resilience and stress-related growth, conveying successful coping in the face of stressful life events (Aldwin et al., 1994;Fontana & Rosenheck, 1998;Jennings, Aldwin, Levenson, Spiro, & Mroczek, 2006). RESILIENCE ACROSS THE LIFE COURSEResilience is a term with different uses. Here we refer to resilience as a process or pattern of adaptation in the context of threats to individual life or function (Masten & Wright, 2010). Although there are multiple ways to conceptualize the pathways of resilience (Bonanno, 2004;Masten & Obradovic, 2008), three pathways are especially relevant to lifespan Address correspondence to Jennifer Moye, VA Boston Healthcare System, Brockton Division, 940 Belmont Street, Brockton, MA 02301. Jennifer.Moye@va.gov. (Masten & Wright, 2010): Resistance, a tendency to display a steady state following a stress or with no marked increase in distress; recovery, initial distress followed by positive adaptation; and transformation, in which adaptive functioning improves after trauma through transformational meaning making or posttraumatic growth (Tedeschi, Park, & Calhoun, 1998). Dynamic processes of change may occur between these trajectories (Aldwin, Levenson, & Kelly, 2009). For example, life course theorists recognize the potential of turning points (Elder & Shanahan, 2006), in the forms of positive social structures and idiosyncratic events, as opportunities for individuals on trajectories of vulnerability after initial trauma to experience stress-related growth in response to subsequent events. This growth may then steer such individuals onto pathways of more resilience (McAdams & Bowman, 2001). Combat veterans may be an ideal population in which to examine these trajectories in the context of life-threatening trauma (Clipp & Elder, 1996). Further, few studies have examined t...

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Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors

Abstract: Results suggest that a cancer diagnosis may lead to enduring feelings of vulnerability as well as positive changes in meaning; however, these perceptions have very different mental health correlates.

Cited by 247 publications

References 42 publications

Physical and psychological long-term and late effects of cancer

Physical and psychological long-term and late effects of cancer

Assessment of spiritual suffering in the cancer context: A systematic literature review

Distress and Resilience After Cancer in Veterans

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