Health-related Quality of Life,Fatigue, and Posttraumatic Growth of Cancer Patients Undergoing Radiation Therapy: A Longitudinal Study

The purpose of this study was to determine health-related quality of life (HRQoL), fatigue, and posttraumatic growth (PTG) among patients with breast or prostate cancer during and following radiation therapy (RT). A total of 91 patients completed measures at three time points as follows: one or two weeks before the start of RT, in the fifth/sixth week of treatment, and four to six weeks post-treatment. Consistent with the previous literature, the results of this study revealed that RT was associated with declines in global HRQoL, Physical Well-being, Social/Family Well-being, and Functional Well-being, as well as an increase in fatigue. By four to six weeks post-treatment, these factors improved significantly and returned to baseline levels with the exception of Social/Family Well-being. The PTG total score and almost all of its subscale scores did not change significantly during the period of the study. However, the subscale of Spiritual Change for PTG significantly increased during the RT, and sustained this improvement at four to six weeks post-treatment. A significant negative correlation was found between Physical Well-being and PTG total score, whereas a significant positive correlation was revealed between Social/Family Well-being and PTG total score. The results from this analysis suggest that a significant decrease in HRQoL is evident in the fifth/sixth week of RT treatment. However, recovery of HRQoL occurs as quickly as a few weeks after the end of treatment. Moreover, patients with high ratings of Social/Family Well-being experience more positive psychological changes (PTG) resulting from the cancer experience.     

Obsessive Compulsive Symptoms Predict Posttraumatic Growth: A Longitudinal Study

Although posttraumatic growth (PTG) has received growing attention, the relationship between PTG and distress remains unclear. This longitudinal study examines the relationship between posttraumatic obsessive-compulsive (OC) symptoms and PTG. Israeli veterans were followed over 17 years using self-report questionnaires of OC symptoms, posttraumatic stress disorder (PTSD), and PTG. Hierarchical regression analyses demonstrated that OC symptoms predicted PTG, even when initial PTG levels and PTSD symptoms were controlled for in the combatants group. These preliminary findings suggest that OC symptoms may play an important role in facilitating psychological growth. Future research is warranted to explore the mechanisms responsible for this relationship.     

脑卒中患者创伤后成长及其影响因素分析

探讨脑卒中患者创伤后成长状况及其影响因素.对200(190例有效)例脑卒中患者进行问卷调查.190例脑卒中患者中,创伤后成长在年龄、经济收入、诊断类型、患病时间、后遗症状、自觉痛苦程度及性格类型方面有差异.创伤后成长与社会支持呈正相关、与应对方式中面对呈正相关,回避呈负相关.多重线性回归分析显示,脑率中患者的创伤后成长与患病时间、年龄、自觉痛苦程度、内向性格、社会支持及面对有关.脑卒中患者创伤后成长状况与多种因素有关,应从多维度、多角度进行干预来改善患者的负性体验,以促进其身心康复.     

Prevalence and Predictors of Posttraumatic Growth in Accidentally Injured Patients

This study examined prevalence and predictors of posttraumatic growth in 180 accidentally injured patients of mainland China in their convalescence stage, investigating its relationships with demographic and accidental injury variables, personality, posttraumatic stress disorder (PTSD) symptoms, and coping styles. Our results showed that posttraumatic growth (PTG) presented mostly in the domain of Relating to Others and indicated that PTG was significantly related to marital status, educational level, personality, coping styles, and PTSD symptoms. Avoidance of PTSD symptoms, Openness to experience, and positive coping were significant predictors of PTG. The findings emphasize that when promoting PTG of accidentally injured patients, healthcare providers should facilitate patients utilizing personal resources, understand PTG coexists with PTSD symptoms, and adjust interventions based on the coping styles the patients have adopted.     

老年急性髓系白血病的治疗

老年急性髓性白血病具有独特的生理及生物学特性。目前尽管治疗手段多样 ,但治疗效果不佳。从哲学的角度观察和分析老年急性髓性白血病的治疗特点 ,根据不同的预后因素选择不同的治疗方法 ,以期实现治疗的个体化和最优化     

Variables Related to Posttraumatic Growth in Turkish Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is a chronic, deteriorative disease, which can cause great psychological distress. Although RA has negative psychological consequences, it may also lead to positive changes, which has been given relatively little attention in the research literature. The Posttraumatic Growth Inventory (PTGI) has been used to evaluate growth in survivor’s thinking, feeling and/or behavior following the experiencing of traumatic or severely adverse life events. The purpose of the current study was to examine the domains of the PTGI and to identify variables related to Posttraumatic Growth (PTG) in 117 RA patients from Turkey, a secular, Islamic, non-western developing country. Results showed that the PTGI has three domains: relationship with others; philosophy of life; and self-perception. Regression analyses showed that problem-focused coping had significant contributions to the total PTG levels and PTGI domains of relationship with others and self-perception. Perceived social support appeared as a significant associate for the total PTG levels and for all three domains. In addition, age and perceived disease severity were found to be significantly related to some domains of PTG. Clinicians, aiming to increase positive experience of RA patients, may need to focus on and facilitate perceived social support and problem-focused coping to facilitate growth experiences.     

Directionality of the Association Between Social Support and Posttraumatic Stress Disorder: A Longitudinal Investigation1

This study examined the nature of the association between social support and posttraumatic stress disorder (PTSD) symptomatology among 2,249 male veterans of the 1990‐1991 Gulf War. Using structural equation modeling, a cross‐lagged panel analysis indicated a strong negative relationship between PTSD at Time 1 and social support at Time 2, while social support at Time 1 did not predict PTSD at Time 2. Findings suggest that, over time, interpersonal problems associated with PTSD may have a detrimental influence on the quality and quantity of available social support resources. It is recommended that greater focus be placed on the interpersonal skills of those suffering from PTSD.     

Spirituality,Distress and Posttraumatic Growth in Breast Cancer Patients

Breast cancer is the most common type of cancer for women and is associated with increased distress. Spirituality and posttraumatic growth (PTG) have been associated with illness adjustment, but the relationship between these variables is still not well understood. A sample of 100 breast cancer patients completed a demographic and clinical questionnaire, the Posttraumatic Growth Inventory, Spiritual and Religious Attitudes in Dealing with Illness, and the Hospital Anxiety and Depression Scale. Results showed an association between PTG, spirituality and distress. Women with a longer diagnosis and recurrence showed more distress. Younger age, recurrent cancer and spirituality predicted higher PTG. Patients’ spirituality should be part of intervention with breast cancer patients since it seems to be related to greater growth and adjustment to the illness.     

乳腺癌患者“创伤后成长”的研究进展

近年来,乳腺癌的发病率不断上升,乳腺癌已逐渐成为危害女性健康的首位恶性肿瘤。手术给患者的身心带来很大伤害,但研究者发现,在与乳腺癌这一疾病做斗争的过程中患者会产生一种正向的心理变化,这就是积极心理学领域研究的创伤后成长。本文从创伤后成长内涵、国内外研究现状、测量工具、影响因素、干预方法等几方面对乳腺癌创伤后成长研究现状进行文献综述,为乳腺癌患者心理护理提供依据。     

Creative,Culturally-Sensitive Counseling for Pediatric Oncology Patients Undergoing Treatment

The author presents culturally relevant strategies for creative counseling with children who have been diagnosed with cancer. In addition, therapeutic foundations and cultural considerations for using creative methods with pediatric oncology populations are discussed. Finally, the author outlines the use of specific creative interventions to assist this population including Beads of Courage, drum therapy, art, games, music, and poetry.     

Posttraumatic Growth and Subjective Well-Being among Caregivers of Chronic Patients: A Preliminary Study

This preliminary study focused on positive phenomena among Israeli family caregivers (spouse, adult child, or parent) of patients with chronic illness hospitalized in a medical rehabilitation hospital. We investigated these caregivers’ posttraumatic growth (PTG) and subjective well-being (positive and negative emotions, life satisfaction), and their associations with the demographic and illness characteristics of the caregivers and patients, respectively. Participants included 74 adult primary caregivers: 28 were the patient’s spouse; 21 were the patient’s child; and 25 were the patient’s parent. Caregivers completed four self-report questionnaires. No significant association emerged between caregivers’ PTG and their negative affect or life satisfaction. Nevertheless, caregivers’ positive affect correlated with their PTG and also predicted it. Moreover, different patterns emerged for the caregiver subgroups (spouse, adult child, or parent): Patients’ children reported lower negative affect and greater life satisfaction than patients’ parents or spouses. Various explanations were discussed, alongside implications for giving recognition and assistance from the medical system to patients’ caregivers.     

Dispositional Mindfulness,Psychological Distress,and Posttraumatic Growth in Cancer Patients

Cancer has different psychological and physical outcomes. The present study was conducted to examine psychological distress, posttraumatic growth, and dispositional mindfulness in cancer patients. A total of 109 cancer patients entered the research. The Five-Facet Mindfulness Questionnaire (FFMQ), the Depression Anxiety Stress Scales (DASS-21), and the Posttraumatic Growth Inventory (PTGI) were used for data collection. The regression analysis revealed that dispositional mindfulness can be a significant predictor of psychological distress and posttraumatic growth in cancer patients. The results also showed that mindfulness is related significantly to psychological outcomes and adaptation in cancer patients and should be further addressed in cancer treatment.     

Investigation of Psychometric Properties of the Georgian Version of Posttraumatic Growth Inventory

This paper reports the analysis of psychometric properties of the Georgian version of the Posttraumatic Growth Inventory (PTGI-Geo). In particular, factor structure, internal consistency of the subscales, gender differences, and relation between traumatic event category and posttraumatic growth (PTG) are examined. The study had 641 participants in two studies (study 1, n = 300; study 2, n = 341 participants). The study revealed that PTGI-Geo consists of four factors, instead of the original five factors; namely, the first three factors (New Possibilities, Relation to Others, and Personal Strength) remained unchanged, while the fourth (Spiritual Change) and the fifth (Appreciation of Life) factors merged and formed a new fourth factor. All four new factors have similar internal consistency as the original inventory. There were also some between-person differences for gender consistent with other research.     

主动反刍、创伤后应激障碍与创伤后成长的关系:一项来自汶川地震后青少年的长程追踪研究

本文以追踪研究的方式, 在汶川地震后3.5年、4.5年和5.5年三个时间点, 采用反刍问卷、创伤后应激障碍问卷和创伤后成长问卷对汶川地震后245名中学生进行调查。通过建立交叉滞后模型, 考察主动反刍、创伤后应激障碍与创伤后成长的相互作用关系。结果发现, 震后3.5~5.5年间, 创伤后应激障碍对主动反刍具有跨时间点的正向预测作用, 主动反刍对创伤后应激障碍跨时间点的预测作用不显著;主动反刍与创伤后成长之间存在跨时间点的相互正向预测关系;创伤后应激障碍与创伤后成长之间跨时间点的直接预测作用不显著, 但震后3.5年的创伤后应激障碍可以通过震后4.5年的主动反刍间接地正向预测震后5.5年的创伤后成长;创伤后应激障碍与创伤后成长的横断关系随着时间历程的变化而逐渐减弱。     

社会支持、主动反刍与创伤后成长的关系:基于汶川地震后青少年的追踪研究

本文以追踪研究的方式,在汶川地震后3.5年、4.5年和5.5年三个时间点,采用社会支持问卷、反刍问卷和创伤后成长问卷对汶川地震后245名中学生进行调查。通过建立交叉滞后模型,考察社会支持、主动反刍与创伤后成长的相互作用关系。结果发现,震后3.5年至5.5年间,社会支持对主动反刍和PTG的跨时间点预测作用不显著;主动反刍对PTG具有显著的跨时间点正向预测作用,但对社会支持的跨时间点预测作用不显著;震后3.5年的PTG对震后4.5年的主动反刍具有显著的跨时间点正向预测作用,但震后4.5年的PTG对震后5.5年的主动反刍的跨时间点预测作用不显著;震后3.5年和4.5年的PTG分别对震后4.5年和5.5年的社会支持的跨时间预测作用均不显著。     

1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会。     

1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会.     

A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components

The purpose of this study was to longitudinally investigate PTSD and depression between Reserve, National Guard, and active duty continuously and dichotomously. The study consisted of Millennium Cohort Study participants and used self-reported symptoms. Repeated measures modeling assessed PTSD and depression continuously and dichotomously over time. A subanalysis among only recently deployed personnel was conducted. Of the 52,653 participants for the PTSD analysis, the adjusted PCL-C means were 34.6 for Reservists, 34.4 for National Guardsmen, and 34.7 for active duty members, respectively. Of the 53,073 participants for depression analysis, the adjusted PHQ-9 means were 6.8, 6.7, and 7.2, respectively. In dichotomous models, Reservists and National Guardsmen did not have a higher risk of PTSD or depression compared with active duty members. Among deployers, Reservists and National Guardsmen had higher odds (odds ratio = 1.16, 95% confidence limit [CL] [1.01, 1.34] and OR = 1.19, 95% CL [1.04, 1.36], respectively) of screening positive for PTSD, but not depression. Although Reserve and National Guard deployers had modestly increased odds of PTSD compared with active duty members, overall there were minimal differences in the risk and symptom scores of PTSD and depression between service components.     

The Phenomenology of Posttraumatic Distress in Older Adult Holocaust Survivors

This paper focuses on the effects of the Holocaust on its survivors more than 55 years after the end of World War II. The emphasis is on survivors who were either adults during the Holocaust and who are now over the age of 70, or survivors who were children during the Holocaust and whose age is now between 56 and 70. The central question was: What kinds of posttraumatic phenomena are seen in older adult survivors? After an overview of the field, the situation of survivors in Israel is presented in 2 ways. Results of a survey of survivors who were referred to Amcha, the National Israeli Center for Psychosocial Support of Survivors of the Holocaust, is provided to give some insight in a clinical population. In addition, 2 case histories of survivors are presented to give a more in-depth perspective. The gap between the data from the questionnaires and the clinical material has relevance for the way in which we conceptualize the late consequences of massive trauma.     

A Longitudinal Investigation of Psychological Disorders in Patients Prior and Subsequent to a Diagnosis of Ovarian Cancer

This longitudinal study investigated levels of anxiety and depression in women who underwent clinical investigations to diagnose a possible ovarian cancer. Women completed the Hospital Anxiety and Depression Scale (HADS), prior to clinical investigations (Time 1), after receiving diagnostic results (Time 2) and at 3 months follow-up (Time 3). Thirty women completed the assessments at Time 1 and Time 2, and 22 women were re-assessed at Time 3. The majority of the sample (56%) scored as a case of anxiety prior to clinical investigations. A significant decrease in anxiety and depression across time was found. Levels of anxiety and depression between women with a subsequent cancer diagnosis and women with a benign result were not significantly different. This study showed that clinical investigations are a highly anxiety-provoking event. In addition, the diagnosis of cancer did not significantly elevate or maintain levels of anxiety and depression compared to a benign diagnosis.